Burden of HIV among young transgender women: factors associated with HIV infection and HIV treatment engagement.
Burden of HIV among young transgender women: factors associated with HIV infection and HIV treatment engagement.
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DOI：
10.1080/09540121.2018.1539213
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发表时间：
2019-01
期刊：
影响因子：
1.7
通讯作者：
Mimiaga MJ
中科院分区：
文献类型：
--
作者：
Jin H;Restar A;Biello K;Kuhns L;Reisner S;Garofalo R;Mimiaga MJ
年轻的跨性别女性（YTW）受艾滋病病毒（HIV）的影响尤为严重，然而，对于与HIV感染和治疗参与相关的因素却知之甚少。我们研究了HIV感染的相关因素以及HIV治疗流程的各个步骤，具体包括知晓自身HIV感染情况、与医疗关怀建立联系、接受抗逆转录病毒治疗（ART）以及坚持ART治疗。我们分析了“生活技能项目”的基线数据，这是一项针对从伊利诺伊州芝加哥市和马萨诸塞州波士顿市招募的有性活动的年轻跨性别女性进行的随机对照试验。我们进行了多变量泊松回归分析，以评估HIV感染的相关因素以及HIV治疗流程的各个步骤。近四分之一（24.7%）的年轻跨性别女性感染了HIV。在感染HIV的年轻跨性别女性中，86.2%知晓自己的HIV状况，72.3%与医疗关怀建立了联系，56.9%正在接受ART治疗，46.2%坚持ART治疗。在过去12个月因费用问题而避免就医的感染HIV的年轻跨性别女性与未因费用问题避免就医者相比，与医疗关怀建立联系的几率更低（比值比=0.55，95%置信区间=0.30，0.99）；没有初级医疗服务提供者的感染HIV的年轻跨性别女性与有初级医疗服务提供者的相比，接受ART治疗的几率更低（比值比=0.11，95%置信区间=0.01，0.74）。没有初级医疗服务提供者的年轻跨性别女性中无人自述坚持ART治疗。我们观察到年轻跨性别女性中HIV治疗参与情况不理想。我们的研究结果表明，通过解决经济障碍和改善获得初级医疗服务提供者的途径来改善与医疗关怀的联系以及在医疗关怀中的留存情况，能够显著改善年轻跨性别女性的健康状况，并减少HIV的传播。
Young transgender women (YTW) are disproportionately affected by HIV, however, little is known about the factors associated with HIV infection and treatment engagement. We examined correlates of HIV infection and the steps of the HIV treatment cascade, specifically, being aware of their HIV infection, linked to care, on ART, and adherent to ART. We analyzed the baseline data of Project LifeSkills, a randomized control trial of sexually active YTW recruited from Chicago, Illinois and Boston, Massachusetts. We conducted multivariable Poisson regressions to evaluate correlates of HIV infection and the steps of the HIV treatment cascade. Nearly a quarter (24.7%) of YTW were HIV-infected. Among HIV-infected YTW, 86.2% were aware of their HIV status, 72.3% were linked to care, 56.9% were on ART, and 46.2% were adherent to ART. HIV-infected YTW who avoided healthcare due to cost in the past 12 months had lower odds of being linked to care (OR=0.55, 95% CI=0.30, 0.99) compared to those who did not, and HIV-infected YTW who do not have a primary care provider had lower odds of being on ART (OR=0.11, 95% CI=0.01, 0.74) compared to HIV-infected YTW who do. No YTW who did not have a primary care provider self-reported being adherent to ART. We observed suboptimal HIV treatment engagement among YTW. Our results suggest that improving linkage and retention in care by addressing financial barriers and improving access to primary care providers could significantly improve health outcomes of YTW as well as reduce forward transmission of HIV.
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DOI：
10.15585/mmwr.mm6633a3
发表时间：
2017-08-25
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Pitasi MA;Oraka E;Clark H;Town M;DiNenno EA
通讯作者：
DiNenno EA
影响因子：
12.7
作者：
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影响因子：
7.6
作者：
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通讯作者：
Harper, GW
影响因子：
--
作者：
Lurie, Samuel
通讯作者：
Lurie, Samuel
影响因子：
4.4
作者：
Reisner SL;Jadwin-Cakmak L;White Hughto JM;Martinez M;Salomon L;Harper GW
通讯作者：
Harper GW