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跨性别女性艾滋病毒暴露前预防 (PrEP) 保留的决定因素:一个连续的,解释性的混合方法研究

Jack Andrzejewski¹, Heather A Pines^2,3,4, Sheldon Morris⁴

¹San Diego Joint Doctoral Program in Public Health, San Diego State University-University of California San Diego, San Diego, CA 92093, USA.

International journal of environmental research and public health

|February 24, 2024

概括

跨性别女性面临着独特的艾滋病毒和PrEP挑战. 生存性工作和药物使用阻碍了PrEP的保留,而性别肯定护理可能会支持它.

科学领域:

公共卫生公共卫生
社会和行为科学社会和行为科学
传染病流行病学传染病流行病学

背景情况:

变性女性 (TW) 经历了重大的健康不平等,包括更高的艾滋病毒流行率.
获得和保持暴露前预防 (PrEP) 对TW的HIV预防至关重要.
独特的障碍可能会影响这个人群的prep坚持和保留.

研究的目的:

检查影响跨性别女性24周口服PrEP保留时间的因素.
探索TW关于PrEP使用和保留的实践经验.
确定持续使用PrEP的特定障碍和促进因素.

主要方法:

使用了一种分为两个阶段的顺序解释混合方法方法.
第一个阶段:对接受口服PrEP的170名TW中24周保留预测因子的定量分析.
第二阶段:对15次深入采访的定性主题分析,这些采访是对曾经使用PrEP的TW进行的.

主要成果:

实质性/严重的药物使用和从事性工作与较低的PrEP保留率有关.
出现了两种性工作类别:"不生存" (更容易保留PrEP) 和"生存" (存在重大障碍).
在那些没有保留的人群中,注意到性别肯定激素治疗 (GAHT) 的使用率较低;然而,参与者看到将GAHT和PrEP服务整合起来有好处.

结论:

生存性工作,药物使用和不稳定的住房对TW的PrEP保留构成重大障碍.
将性别肯定性护理与PrEP服务相结合,可能会提高保留率.
对于面临社会经济和物质使用挑战的TW来说,需要有针对性的支持策略来维持PrEP护理.

关键词:

艾滋病病毒艾滋病病毒艾滋病病毒这就是为什么PrEP是PrEP.性别肯定性别肯定性工作是性工作.使用物质使用物质.跨性别女性,跨性别女性.

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