Characterizing the HIV Care Continuum and Identifying Barriers and Facilitators to HIV Diagnosis and Viral Suppression Among Black Transgender Women in the United States
Characterizing the HIV Care Continuum and Identifying Barriers and Facilitators to HIV Diagnosis and Viral Suppression Among Black Transgender Women in the United States
复制标题
DOI：
10.1097/qai.0000000000001831
复制
发表时间：
2018-12-01
影响因子：
3.6
通讯作者：
Stall, Ronald D.
中科院分区：
文献类型：
--
作者：
Bukowski, Leigh A.;Chandler, Cristian J.;Stall, Ronald D.
背景资料：虽然黑人变性妇女（BTW）在美国的艾滋病毒感染率很高，但对这一人群没有艾滋病毒护理连续体的特征。本研究通过以下方式解决了这一差距：（1）描述艾滋病毒护理连续体的特征，（2）探索基于社区的BTW.Methods样本中艾滋病毒诊断和病毒抑制的相关性：数据来自促进我们的价值，平等和恢复力（POWER）。从2014年到2017年，POWER招募了在美国6个城市参加Black Pride活动的BTW。参与者完成了行为健康调查，并接受了现场艾滋病毒检测。简单的频率被用来描述艾滋病毒的护理连续性，和多变量logistic回归分析被用来确定相关的艾滋病毒诊断和病毒suppress.Results：共422 BTW提供完整的数据，我们的分析，其中45.0%的人是艾滋病毒感染者。超过一半的艾滋病毒阳性BTW（51.4%）报告在调查时未确诊，24.5%报告病毒抑制。在多变量模型中，监禁和缺乏医疗保健与未确诊的艾滋病毒阳性状态显著正相关。监禁，无家可归，多种药物的使用，身体攻击，亲密伴侣的暴力，和目前的激素使用显着和负相关的多变量models.Conclusions病毒抑制：制定和实施干预措施，及时解决艾滋病毒的诊断可能有助于在美国的BTW之间的艾滋病毒的差距。干预措施应解决这一人群健康状况不佳的根本原因。
Background: Although black transgender women (BTW) experience high prevalence of HIV in the United States, no characterization of the HIV care continuum exists for this population. This study addresses this gap by (1) characterizing the HIV care continuum, and (2) exploring correlates of HIV diagnosis and viral suppression among a community-based sample of BTW.Methods: Data came from Promoting Our Worth, Equality, and Resilience (POWER). From 2014 to 2017, POWER recruited BTW who attended Black Pride events in 6 U.S. cities. Participants completed a behavioral health survey and were offered onsite HIV testing. Simple frequencies were used to characterize the HIV care continuum, and multivariable logistic regression analysis was used to identify correlates of HIV diagnosis and viral suppression.Results: A total of 422 BTW provided completed data for our analysis, 45.0% of whom were living with HIV. Over half of the HIV-positive BTW (51.4%) reported being undiagnosed at the time of survey, and 24.5% reported viral suppression. Incarceration and a lack of access to medical care were significantly and positively associated with an undiagnosed HIV-positive status in multivariable models. Incarceration, homelessness, polydrug use, physical assault, intimate partner violence, and current hormone use were significantly and negatively associated with viral suppression in multivariable models.Conclusions: Developing and implementing interventions that address timely HIV diagnosis may assist in informing the HIV disparity among BTW in the United States. Interventions should address the fundamental causes of poor health in this population.