Gender-based differences in non-HIV STI testing among sexually active transgender and nonbinary persons: Bridging gaps in STI research

性活跃的跨性别者和非二元性别者中非艾滋病毒性传播感染检测中基于性别的差异：弥合性传播感染研究中的差距

• 批准号: 10334537
• 负责人: Shanna Katz Kattari
• 金额: $ 7.8万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-01 至 2023-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10334537
• 关键词: Address; Affect; Birth; Centers for Disease Control and Prevention (U.S.); Clinic; Data; Direct Costs; Discrimination; Ecology; Ethnic Origin; Female; Focus Groups; Future; Gender; Gender Identity; General Population; Goals; HIV; HIV risk; Health; Health Care Costs; Health Insurance; Health Services Accessibility; Health Surveys; Healthcare Systems; Human immunodeficiency virus test; Individual; Intervention; Knowledge; Label; Left; Literature; Malignant Neoplasms; Medical; Methods; Michigan; Morbidity - disease rate; Outcome; Participant; Persons; Population; Prevalence; Provider; Public Health; Publishing; Qualitative Research; Race; Recording of previous events; Reporting; Reproductive Health; Research; Respondent; Risk; STI prevention; Sexually Transmitted Diseases; Surveys; Testing; Time; United States; Woman; Women' s Group; base; community transmission; hormone therapy; infection burden; infection rate; male; men; minority stress; programs; sex; sexually active; social; social expectations; social stigma; social structure; testing uptake; theories; transgender; transgender men; transgender women; transmission process

PROJECT ABSTRACT Research suggests that transgender (trans) populations, a diverse group of persons whose gender identity and/or expression differ from societal expectations associated with their sex labelled at-birth, have high rates of non-HIV sexually transmitted infections (STIs). Untreated non- HIV STIs can contribute to negative health outcomes and community transmission. Therefore, access to non-HIV STI testing is of critical importance to mitigate morbidity and promote public health. Of the published research focused on non-HIV STI testing among trans people, studies are limited in population focus (almost exclusively trans women). Notably absent are nonbinary persons (those who do not identify exclusively as men or women), though this group comprises 1/3 of all trans people in the U.S. Scant literature has examined gender-based differences in non- HIV STI testing among trans and nonbinary (TNB) populations. Moreover, information gaps also exist regarding barriers and facilitators to non-HIV STI testing among TNB populations, and how these barriers and facilitators may differ by gender. To address these gaps, our team will examine whether sexually active TNB populations are characterized by gender-based differences (trans women/trans men/nonbinary people) in their rates of non-HIV STI testing and barriers and facilitators to non-HIV STI testing. We will conduct an explanatory sequential mixed-methods study using secondary quantitative data from the 2018 Michigan Trans Health Survey (MTHS) and a primary qualitative study of TNB persons using online focus groups. First, we will determine gender-based differences in a) rates of lifetime non-HIV STI testing history (never, ever) and b) time since last non-HIV STI test (never, past year, 1-5 years, >5 years) among sexually active TNB persons. Then, informed by an integrated conceptual framework drawing on social ecology, minority stress, and gender affirmation, we will examine whether individual (e.g., race/ethnicity), medical (e.g., hormone therapy); social (e.g., provider discrimination based on gender identity); and structural (e.g., clinic gender affirmation) factors are uniquely associated with lifetime non- HIV STI testing history, and whether gender identity moderates the association between lifetime non-HIV STI testing history and statistically significantly associated independent variables. Finally, we will collect and analyze primary qualitative data from TNB persons to further understand their barriers and facilitators to non-HIV STI testing. This study will inform future research focused on developing, evaluating, and implementing interventions which increase non-HIV STI testing among TNB populations, filling critical gaps in research specifically to the needs of overlooked groups of trans men and nonbinary people.

项目摘要 研究表明，跨性别人群（跨性别人群），一群多样的人 性别认同和/或表达与与性别相关的社会期望有所不同 标记为出生，具有高HIV性传播感染率很高（STIS）。未经处理的非 艾滋病毒性传播感染可以导致负面的健康结果和社区传播。所以， 获得非HIV性传播感染测试对于减轻发病率和促进公众至关重要 健康。在跨性别者之间的非HIV性传播感染测试的发表研究中，研究 人口重点有限（几乎完全是跨性别女性）。值得注意的是非二进制 尽管这个群体包括 在美国，所有跨性别者中有1/3的文献研究了基于性别的非性别差异 跨性别和非二进制（TNB）种群中的HIV STI测试。而且，信息差距也 存在于TNB种群中非HIV STI测试的障碍和促进者，以及如何 这些障碍和促进者可能因性别而有所不同。为了解决这些差距，我们的团队将检查 性活跃的TNB种群是否以基于性别的差异为特征（trans 女性/跨性别男性/非二进制人）在非HIV STI测试和障碍率和 非HIV STI测试的促进者。我们将进行解释性的顺序混合方法 使用2018年密歇根州跨性别健康调查（MTHS）的二级定量数据的研究 以及使用在线焦点小组对TNB人员进行的主要定性研究。首先，我们将确定 基于性别的基于性别的差异a）终身非HIV STI测试历史（从不）和b的差异 性活跃的上次非HIV STI测试（从来没有，过去一年，1 - 5年，> 5年） TNB人。然后，通过一个关于社会生态学的综合概念框架的信息， 少数派压力和性别肯定，我们将检查个人（例如种族/种族）是否， 医学（例如激素疗法）；社会（例如，基于性别认同的提供者歧视）； 结构性（例如，临床性别肯定）因素与终生非 - HIV STI测试历史记录以及性别认同是否适度了生命周期之间的关联 非HIV STI测试历史和统计上显着相关的自变量。最后， 我们将收集和分析TNB人员的主要定性数据，以进一步了解他们的 非HIV STI测试的障碍和促进因子。这项研究将为未来的研究提供信息 开发，评估和实施增加非HIV STI测试的干预措施 在TNB人群中，专门针对被忽视的需求填补了关键的研究空白 一群跨性别者和非二进制人群。

项目成果

HIV testing among transgender and nonbinary persons in Michigan, United States: results of a community-based survey.

• DOI: 10.1002/jia2.25972
• 发表时间: 2022-10
• 期刊: Journal of the International AIDS Society
• 影响因子: 6

Sexually transmitted infection testing among transgender and non-binary persons: results of a community-based cross-sectional survey.

跨性别者和非二元性别者的性传播感染检测：基于社区的横断面调查结果。

• DOI: 10.1071/sh22128
• 发表时间: 2023
• 期刊: Sexual health
• 影响因子: 1.6
• 作者: Lacombe-Duncan,Ashley;Kattari,ShannaK;Kattari,Leonardo;Scheim,AydenI;Misiolek,BraydenA
• 通讯作者: Misiolek,BraydenA