Engagement in the HIV Pre-Exposure Prophylaxis Care Cascade in a Statewide Sample of Transgender and Nonbinary Individuals.

IF 3.4 2区 医学 Q2 INFECTIOUS DISEASES AIDS patient care and STDs Pub Date : 2024-11-26 DOI:10.1089/apc.2024.0221
Donald R Gerke, Jarrod Call, Shanna K Kattari, Ashley Lacombe-Duncan, Brayden A Misiolek
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Abstract

Although literature regarding HIV prevention among transgender and nonbinary (TNB) people has grown considerably, important gaps remain, particularly in relation to the HIV pre-exposure prophylaxis (PrEP) care cascade. Additional research is needed to understand when and why TNB people exit the PrEP care cascade to inform interventions to better support these populations. Moreover, most studies have focused on transgender women, though transgender men and nonbinary people also experience a disproportionate prevalence of HIV relative to cisgender populations. This study addresses these gaps by exploring engagement in the PrEP care cascade among a statewide convenience sample of 659 transgender women, transgender men, and nonbinary people, and analyzing how gender identity impacts participant likelihood to continue along the cascade. Data come from the 2018 Michigan Trans Health Study and include self-report data on demographics, sexual behavior, and PrEP awareness, information receipt, referral, initiation, and retention. Participants who self-reported vaginal/front hole or anal sex and did not use barriers (n = 318) were considered eligible for PrEP. Only 21.13% of those eligible for PrEP received information about PrEP, 8.18% were referred to PrEP, and 1.57% initiated PrEP use. A significantly greater proportion of transfeminine and participants who identified with multiple/other genders reported receiving PrEP information than those who identified as transmasculine or nonbinary [χ2 (3, n = 311) =11.34, p = .01]. No other significant gender differences were observed. Providers serving TNB individuals must recognize the diversity of individuals who qualify for information on PrEP, provide trans-affirming care when offering PrEP prescriptions, and consider situating PrEP opportunities in TNB serving spaces to reduce access barriers.

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全州跨性别和非二元性个体样本中参与艾滋病毒暴露前预防护理的情况。
尽管有关变性人和非二元性(TNB)人群艾滋病预防的文献已大幅增加,但仍存在重大差距,尤其是在艾滋病暴露前预防(PrEP)护理级联方面。需要开展更多的研究,以了解 TNB 患者何时以及为何退出 PrEP 护理流程,从而为干预措施提供依据,更好地为这些人群提供支持。此外,大多数研究都集中在变性女性身上,尽管变性男性和非二元人群的 HIV 感染率也比顺性人群高出很多。本研究通过探索全州范围内 659 名变性女性、变性男性和非二元性人群参与 PrEP 护理级联的情况,并分析性别认同如何影响参与者继续参与级联的可能性,从而弥补了这些不足。数据来自 2018 年密歇根变性人健康研究,包括有关人口统计学、性行为、PrEP 意识、信息接收、转诊、启动和保留的自我报告数据。自我报告有阴道/前洞或肛交行为且未使用屏障的参与者(n = 318)被认为符合 PrEP 的条件。在符合 PrEP 条件的人群中,只有 21.13% 的人收到了有关 PrEP 的信息,8.18% 的人被转介到 PrEP,1.57% 的人开始使用 PrEP。在接受 PrEP 信息的参与者中,跨性别者和认同多重/其他性别者的比例明显高于认同跨男性或非二元性别者 [χ2 (3, n = 311) =11.34, p = .01]。没有观察到其他明显的性别差异。为 TNB 患者提供服务的医疗服务提供者必须认识到有资格获取 PrEP 信息的患者的多样性,在提供 PrEP 处方时提供反式肯定护理,并考虑在 TNB 服务场所提供 PrEP 机会,以减少获取信息的障碍。
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来源期刊
AIDS patient care and STDs
AIDS patient care and STDs 医学-传染病学
CiteScore
7.00
自引率
22.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: AIDS Patient Care and STDs is the foremost journal providing the latest developments and research in diagnostics and therapeutics designed to prolong the lifespan and improve quality of life for HIV/AIDS patients. The Journal delivers cutting-edge clinical, basic science, sociologic, and behavior-based investigations in HIV/AIDS and other sexually transmitted infections. Clinical trials, quantitative and qualitative analyses of pilot studies, comprehensive reviews, and case reports are presented from leading experts and scientists around the world. AIDS Patient Care and STDs coverage includes: Prominent AIDS medications, therapies, and antiretroviral agents HIV/AIDS-related diseases, infections, and complications Challenges of medication adherence Current prevention techniques for HIV The latest news and developments on other STDs Treatment/prevention options, including pre- and post-exposure prophylaxis
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