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印度的跨性别女性:解决艾滋病毒护理差距的综合性和交叉框架

William Lodge¹, Shruta Rawat¹, Alpana Dange¹

¹William W. Lodge II is with the Jeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY. At the time of this study, Shruta Rawat, Alpana Dange, and Vivek R. Anand were with The Humsafar Trust, Mumbai, Maharashtra, India. Madina Agénor is with the Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI. Don Operario is with the Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA. Matthew J. Mimiaga is with the Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles. Katie B. Biello is with the Department of Epidemiology, Brown University School of Public Health, Providence, RI.

American journal of public health

|May 1, 2025

概括

印度的跨性别女性因耻辱和歧视而面临HIV护理的重大障碍. 整合综合性理论和交叉性的新框架可以改善艾滋病毒治疗的获取和结果.

科学领域:

公共卫生公共卫生
社会流行病学社会流行病学
健康公平卫生公平

背景情况:

与全国平均水平 (0.2%) 相比,印度的跨性别女性 (TGW) 的艾滋病毒患病率不成比例 (4-8%).
对于TGW来说,获得和保留HIV护理的障碍包括耻辱,贫困和缺乏性别肯定护理,尽管免费的抗逆转录病毒疗法 (ART).
现有的行为框架不足以解决系统压迫对印度艾滋病毒感染TGW的影响.

研究的目的:

提出一个概念框架,整合综合学理论和交叉性.
检查导致印度TGW感染艾滋病毒护理障碍的结构性和综合性因素.
为TGW制定量身定制的干预措施提供信息.

主要方法:

由关键信息提供者提供信息的概念框架的开发.
关键信息人包括艾滋病毒感染的TGW,社区领导人,卫生服务提供者和印度研究人员.
该框架整合了综合学理论和交叉性,以分析健康的结构和社会决定因素.

主要成果:

由歧视性政策驱动的系统性边缘化塑造了社会地位,并加剧了TGWs的HIV护理不平等.
该框架强调了社区动员和集体行动在克服障碍方面的关键作用.
结构性不平等对TGW的HIV护理结果产生了重大影响.

结论:

拟议的框架为开发应对高铁的独特需求的干预提供了基础.
集中社区驱动的战略和解决结构性不平等问题可以改善艾滋病毒护理参与度.
这种方法为改善印度跨性别女性艾滋病毒健康结果提供了一条途径.

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