Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus.
Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus.
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DOI：
10.1007/s12160-013-9565-8
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发表时间：
2014-02
影响因子：
3.8
通讯作者：
Johnson, Mallory O.
中科院分区：
文献类型：
--
作者：
Sevelius, Jae M.;Patouhas, Enzo;Keatley, JoAnne G.;Johnson, Mallory O.
与其他群体相比，跨性别女性感染人类免疫缺陷病毒（HIV）的几率是其他群体的49倍，但目前的治疗努力对她们的服务不足。在性别肯定模式和保健赋权模式的指导下，审查文化上独特的障碍和促进参与和保留艾滋病毒护理的因素，并加强努力，减轻健康差距。通过20个访谈和5个焦点小组（n=38），感染艾滋病毒的跨性别女性讨论了她们参与和坚持艾滋病毒护理和治疗的经历和生活背景。我们的参与者在坚持艾滋病毒护理和治疗方面面临重大挑战，包括由于耻辱和过去的负面经历而避免医疗保健，优先考虑激素治疗，以及对艾滋病毒抗逆转录病毒治疗和激素治疗之间不良相互作用的担忧。接受具有文化能力、对跨性别问题敏感的医疗保健是增强医疗保健能力的有力促进者。提出建议，告知干预研究和指导提供者，强调性别肯定艾滋病毒护理，整合与过渡相关的医疗保健需求。
Transgender women have 49 times the odds of human immunodeficiency virus (HIV) infection compared to other groups, yet they are disproportionately underserved by current treatment efforts. To examine culturally unique barriers and facilitators to engagement and retention in HIV care and strengthen efforts to mitigate health disparities, guided by the Models of Gender Affirmation and Health Care Empowerment. Through 20 interviews and 5 focus groups (n=38), transgender women living with HIV discussed their experiences and life contexts of engagement in and adherence to HIV care and treatment. Our participants faced substantial challenges to adhering to HIV care and treatment, including avoidance of healthcare due to stigma and past negative experiences, prioritization of hormone therapy, and concerns about adverse interactions between antiretroviral treatment for HIV and hormone therapy. Receiving culturally competent, transgender-sensitive healthcare was a powerful facilitator of healthcare empowerment. Recommendations are offered to inform intervention research and guide providers, emphasizing gender affirming HIV care that integrates transition-related healthcare needs.
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