Determinants of Willingness to Use Oral HIV Pre-Exposure Prophylaxis Among Transgender Women in Colombia

Transgender Health, Journal Year: 2025, Volume and Issue: unknown

Published: April 21, 2025

Language: Английский

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An implementation strategy package (video education, HIV self-testing, and co-location) improves PrEP implementation for pregnant women in antenatal care clinics in western Kenya

Frontiers in Reproductive Health, Journal Year: 2023, Volume and Issue: 5

Published: Nov. 17, 2023

Background Pre-exposure prophylaxis (PrEP) is recommended by the World Health Organization and Kenyan Ministry of for HIV prevention in pregnancy postpartum women at risk HIV. Integration PrEP into antenatal care promising, but delivery gaps exist face healthcare provider shortages resource-limited settings. Methods Between May November 2021, we conducted a difference-in-differences study (3 months pre-intervention data collection 3 post-intervention collection) analyzing four intervention facilities, where strategies were implemented, comparison no implemented. We tested combination three implementation strategies—video-based information waiting bay, self-testing, dispensing rooms—to improve delivery. compared absolute changes proportion attendees screened (PrEP penetration), receiving all PrEP-specific steps visit (HIV testing, screening, counseling) fidelity), client knowledge, satisfaction, time service ( priori outcomes); post hoc, offered offer) completing testing. measured perceptions acceptability appropriateness strategies. Results observed significant improvements penetration, offer, knowledge p < 0.05) fidelity that trended towards significance = 0.057). penetration increased 5 percentage points 0.008), 8 0.057), offer 4 0.003) vs. facilities. Client 1.7 out 6 total 0.001) satisfaction 0.7 24 (0.09-min decrease; 0.435) small increase (0.33-min increase; 0.005). testing among those eligible did not change (1.5 point decrease, 0.800). Providers felt acceptable appropriate (median acceptability: 20/20; median appropriateness: 19.5/20). However, levels each step cascade remained suboptimal. Conclusions An strategy package with video information, co-location medication enhanced across several outcomes while substantially increasing wait or decreasing provider-client contact time. Clinical trial registration ClinicalTrials.gov , identifier, NCT04712994.

Language: Английский

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Determinants of HIV Pre-Exposure Prophylaxis (PrEP) Retention among Transgender Women: A Sequential, Explanatory Mixed Methods Study

International Journal of Environmental Research and Public Health, Journal Year: 2024, Volume and Issue: 21(2), P. 133 - 133

Published: Jan. 25, 2024

Transgender women (TW) face inequities in HIV and unique barriers to PrEP, an effective biomedical intervention prevent acquisition. To improve PrEP retention among TW, we examined factors related using a two-phase, sequential explanatory mixed methods approach. In Phase I, used data from trial of 170 TW who were provided oral examine predictors 24-week retention. II, conducted 15 in-depth interviews with PrEP-experienced thematic analysis explain I findings. more participants not retained at 24 weeks reported sex work engagement (18% versus 7%) substantial/severe drug use 8%). as barrier often the context work, identified two subcategories work. engaged “non-survival work” had little difficulty staying on while those “survival struggled stay PrEP. fewer gender-affirming hormone therapy (GAHT) (56% 71%). prioritized medical gender affirmation services over but also described bidirectional benefits accessing GAHT experience (e.g., unstable housing, use) may require additional support care.

Language: Английский

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HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

Journal of the International AIDS Society, Journal Year: 2024, Volume and Issue: 27(2)

Published: Feb. 1, 2024

Abstract Introduction Current implementation efforts have failed to achieve equitable HIV pre‐exposure prophylaxis (PrEP) provision for transgender and gender‐diverse (trans) populations. We conducted a choice‐based conjoint analysis measure preferences key attributes of hypothetical PrEP delivery programmes among diverse online sample predominantly comprised transmasculine nonbinary individuals in the United States. Methods Between April 2022 June 2022, national survey with an embedded experiment was 304 trans aged ≥18 years States assess five programme attributes: out‐of‐pocket cost; dispensing venue; frequency visits PrEP‐related care; travel time provider; ability bundle care gender‐affirming hormone therapy services. Participants responded questions, each which presented two scenarios one opt‐out option per question selected their preferred question. used hierarchical Bayes estimation multinomial logistic regression part‐worth utility scores total by respondents’ status. Results The median age 24 (range 18–56); 75% were assigned female sex at birth; 54% identified as transmasculine; 32% nonbinary; 14% transfeminine. Out‐of‐pocket cost had highest attribute importance score (44.3%), followed services (18.7%). Minimal cost‐sharing ($0 cost) most positively influenced (average coefficient 2.5 [95% CI 2.4−2.6]). PrEP‐experienced respondents primary settings (relative 4.7); however, PrEP‐naïve pharmacies 5.1). Conclusions that offered without bundled Bolstering federal regulations cover prioritizing expand low‐barrier are critical achieving provision. Community‐engaged research close collaboration community stakeholders researchers needed streamline design patient‐centred develop strategies salient sexual health needs patients.

Language: Английский

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Barriers and facilitators to HIV pre-exposure prophylaxis uptake among transgender women in Colombia: A qualitative analysis using the COM-B model

PLOS Global Public Health, Journal Year: 2023, Volume and Issue: 3(9), P. e0001395 - e0001395

Published: Sept. 27, 2023

Transgender women [TGW] in Colombia are disproportionately affected by HIV due to their low sociodemographic conditions, varied risk behaviours, difficulty accessing health services, and discrimination. Offering pre-exposure prophylaxis [PrEP] as part of a combination prevention strategies is an appropriate option for this population reduce infection. However, little known about how implement PrEP program TGW Colombia. Between June October 2020, we conducted individual interviews with 16 from four different cities The assessed contextual influences, knowledge, skills, perceptions, beliefs. We used qualitative thematic analysis identify themes the Capability, Opportunity, Motivation, Behavior framework further delineate barriers possible interventions. After delineating main across three subdomains model, nine were identified: one related capability, perception PrEP; six opportunity, which includes, family relations, sexual work environment, stable partner interactions healthcare workers, service provision, community opportunities; two motivation, mental health, concerns medication side effects. Mapping interventions generated following intervention functions: education, training, enablement, environmental structure; policy communication/marketing, legislation, changes provision. Examples presented discussed.

Language: Английский

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Establishing Evidence Criteria for Implementation Strategies: A Delphi Study for HIV Services

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: Feb. 29, 2024

Background. There are no criteria specifically for evaluating the quality of implementation research and recommend strategies likely to have impact practitioners. We describe development application Best Practices Rubric, a set evaluate evidence supporting strategies, in context HIV. Methods. developed Rubric from 2022–2023 three phases. (1) purposively selected recruited by email participants representing mix expertise HIV service delivery, improvement, science. draft rubric based on literature review key informant interviews. (2) The was then informed revised through two e-Delphi rounds using survey delivered online Qualtrics. first second round Delphi surveys consisted 71 52 open close-ended questions, respectively, asking evaluate, confirm, make suggestions different aspects rubric. After each round, data were analyzed synthesized as appropriate, revised. (3) applied studies assessing 18 designed promote adoption uptake pre-exposure prophylaxis, an prevention medication, assess reliable criteria. Results. Our initial yielded existing rubrics intervention-level evidence. For strategy-level rubric, additions emerged interviews, example, need consider specification strategies. Revisions made after both resulting confirmation five evaluation domains – design, outcomes, limitations rigor, strategy specification, equity four levels best practice, promising more needed, harmful practices. most domains, specified at level. pilot develop process provide training, we achieved 98% reliability when applying Conclusions. services. Although is specific HIV, this tool adaptable other health areas.

Language: Английский

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Establishing evidence criteria for implementation strategies in the US: a Delphi study for HIV services

Implementation Science, Journal Year: 2024, Volume and Issue: 19(1)

Published: July 15, 2024

There are no criteria specifically for evaluating the quality of implementation research and recommending strategies likely to have impact practitioners. We describe development application Best Practices Tool, a set evaluate evidence supporting HIV-specific strategies.

Language: Английский

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Pre-exposure Prophylaxis (PrEP) implementation among latino MSM: a qualitative scoping review of implementation determinants and change methods

Implementation Science Communications, Journal Year: 2024, Volume and Issue: 5(1)

Published: Sept. 30, 2024

Language: Английский

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Innovation and implementation determinants of HIV testing and linkage-to-care in the U.S.: a systematic review

Implementation Science Communications, Journal Year: 2024, Volume and Issue: 5(1)

Published: Oct. 8, 2024

To identify innovation and implementation determinants of HIV testing, diagnosis, linkage-to-care in the U.S.

Language: Английский

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Transgender Latinas’ Perspectives on HIV PrEP Uptake, Condom Use, and Medically Supervised Gender-Affirming Hormone Therapy: Insights From ChiCAS Qualitative Interviews

AIDS Education and Prevention, Journal Year: 2024, Volume and Issue: 36(5), P. 369 - 386

Published: Oct. 1, 2024

There is a dearth of HIV prevention behavioral interventions for transgender Latinas, despite this population's risk. ChiCAS (Chicas Creando Acceso la Salud) an intervention to increase PrEP, condom, and gender-affirming hormone therapy (GAHT) use among Latinas. To inform future work, semistructured interviews were conducted postintervention with 28 participants. Thematic analysis inductive coding was used. Six themes emerged: (1) health-related priorities include sexual health avoiding discrimination; (2) safe collaborative community high importance; (3) interactive education time sharing stories discussion valued; (4) PrEP uptake facilitated through awareness care navigation; (5) accessing GAHT depends on cost, clinic location, individual goals; (6) could be improved more PrEP/GAHT details social connection. Interventions goals similar those should prioritize building community, tailored participants' needs, emphasize options available locally.

Language: Английский

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