This protocol describes a 20-year prospective cohort study, gathering behavioral and psychosocial information on clients who access services of the Institute of HIV Research and Innovation (IHRI) and the Thai Red Cross AIDS Research Centre through the Thai Red Cross Anonymous Clinic, the Thai Red Cross Mobile Clinics, Affiliated Health Clinics, The gender and immunity clinic and Pribta Tangerine Polyclinic. Services provided through these sites include VCT, STD screening and treatment, anal and cervical Pap smears, general health checkups, sexual health education, and sexual health communication, gender-affirmative hormone therapy (GAHT) and risk-reduction via web boards and chat rooms.
Behavioral and psychosocial information will be collected using validated questionnaires and from data collection forms routinely used when providing services in different service sites of IHRI and the TRC-ARC. The information will be collected anonymously at baseline and at follow-up visits, according to type of services each client receives. Clients at the Thai Red Cross Anonymous Clinic, Thai Red Cross Mobile Health Clinics, Affiliated Health Clinics and Pribta Tangerine Polyclinic will be given an identification number.
Qualitative methods, including focus group discussions (FGD) and in-depth interviews (IDI) will be conducted with clients and healthcare providers to examine the facilitators, barriers, feasibility and acceptability of service implementation.
18 years or 16 and 17 years of age with parental or guardian consent In non- or pre-SRS cases
Verbal informed consent or signed informed consent on file
No exclusionary medical conditions
Approved by physician
None
Study population: Clients accessing services of the Pribta Tangerine Polyclinic, the Thai Red Cross Anonymous Clinic, the Thai Red Cross Mobile Clinics and Affiliated Health Clinics.
Cohort
Prospective
Demographic characteristics
Behavioral* Gender identity * Sex assigned at birth * Age * Address * History of study enrollment(s)
Social and sexual behaviors
Behavioral* Places where clients go for shopping, dining out, exercise, entertainment * Places where clients meet their sexual partner(s) * Places where clients obtain condoms and lubricants * Social networking and other online services clients regularly use and purposes of using * Lifetime and current sexual practices and condom use * Number and types of sexual partners * Self-perceived HIV risk level * Disclosure of HIV or sexual orientation status
Psychosocial characteristics
Behavioral* Sexual orientation * Educational level * Occupation and income * Attitude towards and use of HIV testing and sexual health services * Use of injecting drugs, recreational drugs, and alcohol
Clinical characteristics
Behavioral* Medical history, including gender dysphoria and hormone therapy * HIV counseling and testing * Diagnosis and treatment of sexually transmitted diseases (STD) * Sample collection information * Laboratory results * Gender dysphoria and mental health history * Body hair pattern * Bridging therapy * Fertility and reproductive issues * Gender transition effects
Referral and linkage to care for HIV-positive clients
Behavioral* Health insurance scheme * Initiation and continuation of antiretroviral treatment
Characteristics associated with service implementation
Behavioral\- Facilitators, barriers, feasibility and acceptability of and satisfaction with service implementation as identified by clients and healthcare providers
Primary Outcome Measure
1. Demographic characteristics 2. Social and sexual behaviors 3. Psychosocial characteristics 4. Clinical characteristics 5. Referral and linkage to care for HIV-positive clients 6. Characteristics associated with service implementation
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