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在格鲁吉亚的跨性别者中,艾滋病毒检测的障碍和促进因素:使用COM-B框架的定性研究结果

Marine Gogia^1,2, Tamar Zurashvili^1,2, Jack DeHovitz³

¹Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia.

PLOS global public health

|March 6, 2026

概括

格鲁吉亚的跨性别者面临艾滋病毒检测的障碍,包括耻辱和有限的知识. 社区支持和可访问的服务,如自我测试,可以提高测试的普及率.

科学领域:

公共卫生公共卫生
社会科学社会科学社会科学
健康公平卫生公平

背景情况:

跨性别 (TG) 人口在全球范围内经历了不成比例的高艾滋病毒负担,污名,歧视和医疗保健准入障碍加剧了这种负担.
在格鲁吉亚,TG个体 (24.1%) 中的艾滋病毒患病率明显高于一般人口 (0.3%).
了解影响格鲁吉亚TG个体HIV检测行为的因素对于有针对性的干预至关重要.

研究的目的:

探索在格鲁吉亚的跨性别者和非二进制个体中对艾滋病毒检测的障碍和促进者.
应用能力,机会,动机-行为 (COM-B) 模型来理解艾滋病毒检测行为.
为改善这一群体艾滋病毒检测覆盖率的策略提供信息.

主要方法:

进行了15次深入的采访,对TG和18-45岁的非二进制个体进行了深入的采访.
参与者是艾滋病毒阴性,而不是暴露前预防 (PrEP).
对转录的数据进行主题分析,映射到COM-B框架.

主要成果:

确定的主要障碍包括有限的艾滋病毒知识,低感知风险,保密恐惧,医疗保健耻辱,地理挑战和物质使用/心理健康问题.
促进者包括对免费/匿名服务的认识,基于社区的外展/自我测试,风险感知,社区支持,社交媒体和激励措施.
艾滋病毒检测行为受到交叉个体,结构和社会文化因素的影响.

结论:

基于社区的组织,同行支持和自我测试减轻了障碍,提高了参与度.
持续存在的挑战,如耻辱,低艾滋病毒识字率,地理不平等和物质使用,阻碍了测试的普及.
扩大分散的,社区驱动的,保密的测试,有针对性的教育和减少耻辱感,对于改善格鲁吉亚TG个人的艾滋病毒测试覆盖率至关重要.

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