Trans-inclusive Sexual Health Questionnaire to Improve Human Immunodeficiency Virus/Sexually Transmitted Infection (STI) Care for Transgender Patients: Anatomic Site-Specific STI Prevalence and Screening.
Trans-inclusive Sexual Health Questionnaire to Improve Human Immunodeficiency Virus/Sexually Transmitted Infection (STI) Care for Transgender Patients: Anatomic Site-Specific STI Prevalence and Screening.
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跨性别性健康调查问卷，以改善跨性别患者的人类免疫缺陷病毒/性传播感染 (STI) 护理：解剖部位特定 STI 患病率和筛查。
DOI：
10.1093/cid/ciac370
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Barbee,LindleyA
中科院分区：
文献类型：
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作者：
Tordoff,DianaM;Dombrowski,JuliaC;Ramchandani,MeenaS;Barbee,LindleyA
背景2018年，西雅图市性健康诊所在诊所的计算机辅助自我访谈（CASI）中实施了有关性行为、解剖学、性别确认手术和性传播感染（STI）症状的跨性别问题，以改善对跨性别和非二元性别（TNB）患者的护理。方法我们计算了测试阳性率，即接受人类免疫缺陷病毒（HIV）检测的TNB患者就诊的比例；梅毒;咽、直肠和泌尿生殖淋病 (GC)；实施新 CASI 问题之前（5/2016-12/2018）和实施后（12/2018-2/2020）衣原体（CT），以及根据报告的暴露情况接受解剖部位特异性筛查的无症状患者的比例。结果每个时期有 434 名 TNB 患者分别进行了 489 次和 337 次就诊。出生时被指定为男性 (AMAB) 的非二元性别患者的 GC 患病率最高（咽部 10%，直肠 14%，泌尿生殖部 12%）。跨性别女性、跨性别男性和非二元性别人群 AMAB 的直肠 CT 患病率较高（分别为 10%、9% 和 13%），梅毒患病率较高（分别为 9%、5% 和 8%）。与出生时被指定为女性的非二元性别患者相比，无症状的跨性别女性、跨性别男性和非二元性别患者 AMAB 更有可能接受生殖器外 GC/CT 筛查。实施跨性别问题后，TNB 患者每年就诊的人数增加了 33%，但 TNB 患者的 HIV/STI 检测没有显着增加。结论 TNB 人群生殖器外 STI 和梅毒的患病率较高。在为顺性别和跨性别患者提供服务的诊所实施跨性别病史问题是可行的，对于提高肯定性和包容性性保健的质量也很重要。
BackgroundIn 2018, the municipal Sexual Health Clinic in Seattle, implemented trans-inclusive questions about sexual behavior, anatomy, gender-affirming surgeries, and sexually transmitted infection (STI) symptoms in the clinic’s computer-assisted self-interview (CASI) to improve care for transgender and nonbinary (TNB) patients.MethodsWe calculated test positivity, the proportion of TNB patient visits that received testing for human immunodeficiency virus (HIV); syphilis; pharyngeal, rectal, and urogenital gonorrhea (GC); and chlamydia (CT) before (5/2016–12/2018) and after (12/2018–2/2020) implementation of new CASI questions, and the proportion of asymptomatic patients who received anatomic site–specific screening based on reported exposures.ResultsThere were 434 TNB patients with 489 and 337 clinic visits during each period, respectively. Nonbinary patients assigned male at birth (AMAB) had the highest prevalence of GC (10% pharyngeal, 14% rectal, 12% urogenital). Transgender women, transgender men, and nonbinary people AMAB had a high prevalence of rectal CT (10%, 9%, and 13%, respectively) and syphilis (9%, 5%, and 8%). Asymptomatic transgender women, transgender men, and nonbinary patients AMAB were more likely to receive extragenital GC/CT screening compared with nonbinary patients assigned female at birth. After implementation of trans-inclusive questions, there was a 33% increase in the number of annual TNB patient visits but no statistically significant increase in HIV/STI testing among TNB patients.ConclusionsTNB people had a high prevalence of extragenital STIs and syphilis. Implementation of trans-inclusive medical history questions at a clinic that serves cisgender and transgender patients was feasible and important for improving the quality of affirming and inclusive sexual healthcare.