"I felt special!": a qualitative study of peer-delivered HIV self-tests, STI self-sampling kits and PrEP for transgender women in Uganda.
"I felt special!": a qualitative study of peer-delivered HIV self-tests, STI self-sampling kits and PrEP for transgender women in Uganda.
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DOI：
10.1002/jia2.26201
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发表时间：
2023-12
影响因子：
6
通讯作者：
Haberer JE
中科院分区：
文献类型：
--
作者：
Mujugira A;Karungi B;Mugisha J;Nakyanzi A;Bagaya M;Kamusiime B;Nalumansi A;Nalukwago GK;Kasiita V;Twesigye CC;Nampewo O;Nsubuga R;Nyanzi KR;Muwonge T;Wyatt MA;Ware NC;Haberer JE
同伴递送是一种以客户为中心的方法，可以最大限度地扩大艾滋病毒服务对变性人妇女的覆盖面和影响。我们进行了定性访谈，以检验同伴递送的艾滋病毒自我检测(HIVST)、性传播感染自我抽样(STISS)和口服暴露前预防(PrEP)如何影响乌干达TGW及其亲密伴侣的预防选择。在一项关于HIV阴性TGW(NCT04328025)中同伴提供的HIVST、STISS和PrEP的整群随机试验中，我们对30名TGW、15名亲密伴侣和10名TGW同伴(2021年8月至2022年2月)进行了55次定性访谈。TGW访谈探讨了：(1)HIV自我检测和PrEP经历；(2)与亲密伴侣的HIVST；(3)用于STI检测的自我采样的描述。性伴侣访谈包括：(1)感染艾滋病毒的经历；(2)向亲密伴侣披露艾滋病毒状况；(3)对检测后的性行为进行描述。同伴访谈的主题包括：(1)干预的实施经验；(2)对TGW的同伴提供的艾滋病毒预防服务的建议，包括心理支持和应对策略。定性数据采用归纳含量分析方法进行分析。同行提供的联合预防受到这组TGW及其合作伙伴的重视。(1)同行服务不仅仅是提供艾滋病毒/性传播感染试剂盒和PrEP补充物，还通过提供耻辱应对战略，照顾个人的健康和福祉。同伴心理社会支持使研究参与者成为“HIVST大使”，教授非学习TGW关于自我测试和PrEP的知识，并鼓励联系到关怀。(2)与亲密伴侣的艾滋病毒感染和相互披露艾滋病毒状况加强了伙伴关系。在双方艾滋病毒检测结果为阴性后使用Prep意味着不忠。(3)自我采样使TGW能够控制他们的STI测试，避免暴露自己身体的尴尬。隐私和保密性促进了性传播感染检测和治疗的采用。在这个来自乌干达的TGW样本中，同行提供HIVST、STISS和PrEP补充剂使个人预防工作受益，并扩展到不从事护理的TGW的新联系。将对等服务整合到差异化的PrEP交付中，可以增加艾滋病毒/性传播感染检测的覆盖率，并在这一弱势群体中使用PrEP。
Peer delivery is a client‐centred approach that could maximize the coverage and impact of HIV services for transgender women (TGW). We conducted qualitative interviews to examine how peer‐delivered HIV self‐testing (HIVST), sexually transmitted infection self‐sampling (STISS) and oral pre‐exposure prophylaxis (PrEP) influenced prevention choices among TGW and their intimate partners in Uganda. Within a cluster randomized trial of peer‐delivered HIVST, STISS and PrEP among HIV‐negative TGW (NCT04328025), we conducted 55 qualitative interviews with 30 TGW, 15 intimate partners and 10 TGW peers (August 2021–February 2022). TGW interviews explored: (1) HIV self‐test and PrEP experiences; (2) HIVST with intimate partners; and (3) descriptions of self‐sampling for STI testing. Partner interviews covered: (1) experiences with HIVST; (2) disclosure of HIV status to intimate partner; and (3) descriptions of sexual behaviours after testing. Peer interview topics included: (1) intervention delivery experiences; and (2) recommendations for peer‐delivered HIV prevention services to TGW, including psychological support and coping strategies. Qualitative data were analysed using an inductive content analytic approach. Peer‐delivered combination prevention was valued by this group of TGW and their partners. (1) Peer services extended beyond delivering HIV/STI kits and PrEP refills to caring for individual health and wellbeing by providing stigma coping strategies. Peer psychosocial support empowered research participants to become “HIVST ambassadors,” teach non‐study TGW about self‐testing and PrEP, and encourage linkage to care. (2) HIVST with intimate partners and mutual disclosure of HIV status strengthened partnered relationships. PrEP use after both partners tested HIV negative implied infidelity. (3) Self‐sampling enabled TGW to take control of their STI testing and avoid the embarrassment of exposing their bodies. Privacy and confidentiality motivated the uptake of STI testing and treatment. In this sample of TGW from Uganda, peer delivery of HIVST, STISS and PrEP refills benefitted individual prevention efforts and extended to a new linkage of TGW not engaged in care. Integrating peer services into differentiated PrEP delivery could increase HIV/STI test coverage and PrEP use in this vulnerable population.
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影响因子：
4.4
作者：
Iribarren S;Lentz C;Sheinfil AZ;Giguere R;Lopez-Rios J;Dolezal C;Frasca T;Balán IC;Tagliaferri Rael C;Brown W 3rd;Cruz Torres C;Crespo R;Febo I;Carballo-Diéguez A
通讯作者：
Carballo-Diéguez A
呼吁差异化方法向关键人群提供艾滋病毒服务。
影响因子：
6
作者：
Macdonald V;Verster A;Baggaley R
通讯作者：
Baggaley R
影响因子：
2.8
作者：
Guta A;Flicker S;Roche B
通讯作者：
Roche B
影响因子：
15.8
作者：
Poteat T;Ackerman B;Diouf D;Ceesay N;Mothopeng T;Odette KZ;Kouanda S;Ouedraogo HG;Simplice A;Kouame A;Mnisi Z;Trapence G;van der Merwe LLA;Jumbe V;Baral S
通讯作者：
Baral S
影响因子：
4.9
作者：
Frye, Victoria;Wilton, Leo;Kobin, Beryl
通讯作者：
Kobin, Beryl