TransOdara study: the challenge of integrating methods, settings and procedures during the COVID-19 pandemic in Brazil

Revista Brasileira de Epidemiologia, Год журнала: 2024, Номер 27(suppl 1)

Опубликована: Янв. 1, 2024

Sexually transmitted infections (STIs) disproportionately affect transgender women and travestis (TGW), who often lack access to healthcare due stigma discrimination. We describe the approach methodology of a study investigating prevalence syphilis, HIV, hepatitis A, B, C, Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), human papillomavirus (HPV) among TGW, as well their knowledge perceptions regarding better inform policies curb STIs this vulnerable population.

Язык: Английский

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Self-sampling strategies (with/without digital innovations) in populations at risk ofChlamydia trachomatisandNeisseria gonorrhoeae: a systematic review and meta-analyses

Sexually Transmitted Infections, Год журнала: 2023, Номер 99(6), С. 420 - 428

Опубликована: Март 29, 2023

Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) resulted in over 200 million new sexually transmitted infections last year. Self-sampling strategies alone or combined with digital innovations (ie, online, mobile computing technologies supporting self-sampling) could improve screening methods. Evidence on all outcomes has not yet been synthesised, so we conducted a systematic review meta-analysis to address this limitation. Methods We searched three databases (period: 1 January 2000–6 2023) for reports self-sampling CT/GC testing. Outcomes considered inclusion were: accuracy, feasibility, patient-centred impact changes linkage care, first-time testers, uptake, turnaround time referrals attributable self-sampling). used bivariate regression models meta-analyse accuracy measures from self-sampled tests obtain pooled sensitivity/specificity estimates. assessed quality Cochrane Risk of Bias Tool-2, Newcastle–Ottawa Scale Quality Assessment Diagnostic Accuracy Studies-2 tool. Results summarised results 45 studies reporting (73.3%; 33 45) (26.7%; 12 10 high-income (HICs; n=34) 8 low/middle-income countries (LMICs; n=11). 95.6% (43 were observational, while 4.4% (2 randomised clinical trials. noted that sensitivity (n=13) was higher extragenital (>91.6% (86.0%–95.1%)) than vaginal (79.6% (62.1%–90.3%)), specificity remained high (>99.0% (98.2%–99.5%)). Participants found highly acceptable (80.0%–100.0%; n=24), but preference varied (23.1%–83.0%; n=16). reached 51.0%–70.0% (n=3) testers 89.0%–100.0% linkages care. Digital led 65.0%–92% engagement 43.8%–57.1% kit return rates (n=3). varied. Discussion had mixed sensitivity, accepted recommend HICs additional evaluations LMICs. impacted may reduce disease burden hard-to-reach populations. PROSPERO registration number CRD42021262950.

Язык: Английский

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Access Barriers in Testing for Sexually Transmitted Infections across Gender and Sexual Identities

Clinics in Laboratory Medicine, Год журнала: 2024, Номер 44(4), С. 647 - 663

Опубликована: Авг. 16, 2024

Язык: Английский

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Barriers to Healthcare for Transgender Individuals

Journal of Doctoral Nursing Practice, Год журнала: 2024, Номер 17(2), С. 110 - 116

Опубликована: Июнь 26, 2024

Язык: Английский

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Physical examination for the detection of sexually transmitted infections among transgender women and travestis in Brazil: acceptability and associated factors

Revista Brasileira de Epidemiologia, Год журнала: 2024, Номер 27(suppl 1)

Опубликована: Янв. 1, 2024

This study aimed to determine the acceptability and factors associated with uptake of a physical examination for detection symptomatic sexually transmitted infections (STIs) by transgender women travestis in Brazil.

Язык: Английский

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“I felt special!”: a qualitative study of peer‐delivered HIV self‐tests, STI self‐sampling kits and PrEP for transgender women in Uganda

Journal of the International AIDS Society, Год журнала: 2023, Номер 26(12)

Опубликована: Дек. 1, 2023

Abstract Introduction 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 self‐testing (HIVST), sexually transmitted infection self‐sampling (STISS) oral pre‐exposure prophylaxis (PrEP) influenced prevention choices among TGW their intimate partners in Uganda. Methods Within cluster randomized trial HIVST, STISS PrEP HIV‐negative (NCT04328025), we 55 with 30 TGW, 15 10 peers (August 2021–February 2022). explored: (1) self‐test experiences; (2) HIVST partners; (3) descriptions STI testing. Partner covered: experiences HIVST; disclosure status partner; sexual behaviours after interview topics included: intervention recommendations including psychological support coping strategies. Qualitative data were analysed using an inductive content analytic approach. Results Peer‐delivered combination was valued by this group partners. extended beyond delivering HIV/STI kits refills caring individual health wellbeing providing stigma psychosocial empowered research participants become “HIVST ambassadors,” teach non‐study about PrEP, encourage linkage care. mutual strengthened partnered relationships. use both tested negative implied infidelity. Self‐sampling enabled take control testing avoid embarrassment exposing bodies. Privacy confidentiality motivated uptake treatment. Conclusions In sample from Uganda, peer benefitted efforts new not engaged Integrating into differentiated increase test vulnerable population.

Язык: Английский

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Sexual Health Care for Transgender and Gender Diverse People

Medical Clinics of North America, Год журнала: 2023, Номер 108(2), С. 393 - 402

Опубликована: Окт. 29, 2023

Язык: Английский

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Anal self-exam is a valuable screening tool for anal cancer in sexual and gender minority persons

The Lancet Regional Health - Americas, Год журнала: 2024, Номер 33, С. 100742 - 100742

Опубликована: Апрель 9, 2024

Addressing disparities in cancer prevention and treatment among sexual gender minorities (SGM) is a national health priority given that they experience higher rates of worse physical mental outcomes compared to the general population.1Jackson S.S. Han X. Mao Z. et al.Cancer stage, treatment, survival transgender patients United States.J Natl Cancer Inst. 2021; 113: 1221-1227Crossref PubMed Scopus (57) Google Scholar,2Cancer Report.org. American Association for Research, Philadelphia2022www.cancerdisparitiesprogressreport.orgGoogle Scholar The study by Dr. Nyitray colleagues3Nyitray A.G. McAuliffe T.L. Liebert C. al.The accuracy anal self- companion exams minority men women: prospective analysis.Lancet Reg Health Am. 2024; 31100704https://doi.org/10.1016/j.lana.2024.100704Summary Full Text PDF (0) touches upon this significant, yet under-addressed, healthcare burden who have sex with (MSM) women (TW). Anal cancer, most commonly squamous cell carcinoma caused Human Papillomavirus (HPV), has been on rise States.4Deshmukh A.A. Suk R. Shiels M.S. al.Recent trends anus incidence mortality States, 2001–2015.J 2020; 112: 829-838Crossref (170) A coalescence unique risk factors, barriers care access, limitations screening guidelines infrastructure underscores importance addressing MSM TW, groups disproportionately impacted.5Fein L.A. Cunha I.R. Wong A. Schlumbrecht M.P. Duthely L.M. Potter J.E. Low perceived utilization high-risk living an HIV/STI epicenter.AIDS Behav. 25: 2210-2218Crossref (5) Scholar, 6Stier E.A. Clarke M.A. Deshmukh al.International Neoplasia Society's consensus screening.Int J Cancer. 154: 1694-1702Crossref (3) 7LGBT populations' care.Semin Oncol Nurs. 2018; 34: 21-29Crossref (37) Nitray al. done excellent job highlighting all these challenges providing meaningful results provide confidence self-screening as tool early detection. Among there often hesitance accessing routine screenings due longstanding stigmatization mistreatment imposed populations system.8Ayhan C.H.B. Bilgin H. Uluman O.T. Sukut O. Yilmaz S. Buzlu systematic review discrimination against settings.Int Serv. 50: 44-61Crossref (190) expansive persons, such encounters professionals can result uncomfortable unnecessary questioning, which exacerbate dysphoria. Therefore, self-conducted testing screening, when medically appropriate, strategy mitigate distress some encounters. It shown be both feasible acceptable, even preferred, persons.9Prétet J.L. Baraquin Barret A.S. al.Anal oropharyngeal HPV distribution HIV-negative multipartner using self-sampling kits HIV sexually transmitted infection screening.J Med Virol. 2023; 95e29068Crossref Scholar,10McCartney D.J. Pinheiro T.F. Gomez Carvalho PGCd Veras Mayaud P. Acceptability etiological diagnosis mucosal infections (STIs) longitudinal cohort São Paulo, Brazil.Braz Infect Dis. 2022; 26102356Crossref TW are also more likely uninsured face socioeconomic healthcare,11Bosworth Turrini G. Pyda al.Health insurance coverage access LGBTQ+ individuals: current key challenges.Office Policy. (2021-07. Issue Brief No. HP-2021-14)Google further underscoring developing evaluating mechanisms self-testing. International Society (IANS) recently released groups, particular TW.6Stier These were founded landmark national, multi-site (ANCHOR) demonstrated high-grade intraepithelial lesions (HSIL) could reduce risk.12Palefsky J.M. Lee J.Y. Jay N. al.Treatment prevent cancer.N Engl Med. 386: 2273-2282Crossref (147) In IANS guidelines, digital rectal examinations (DARE) recommended at visits combination swab collection cytology and/or testing. Abnormal should prompt referral high resolution anoscopy (HRA). acknowledges inherent HRA infrastructure, requires costly equipment training currently only accessible large cities Western Europe, Australia. those other medical societies, underscore DARE particularly services not available. Given HRA, truly cornerstone remains important arsenal prevention. For SGM self or partner exams, while substitute DARE, promising detection early-stage successful. Self-exams invaluable healthcare, present new application concept meaningfully impact Development implementation educational tools awareness strategies, concert community engagement support, will crucial widespread adoption method. Future self-exams, their application, acceptability including transmasculine non-binary individuals assigned female birth, would necessary insight into vulnerable groups. I applaud presents sensitive approach important, neglected, aspect seeks overcome known faced population. Lydia Fein MD MPH: literature search, writing. Rebecca L. Barnett: writing, review, editing. No conflicts interest. Funding: None. analysisSexual men/transgender may self-detect SCCA malignant much smaller than mean dimension presentation ≥30 mm. Full-Text Open Access

Язык: Английский

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Quality, acceptability and usability of self-sampling kits used by non-healthcare professionals for STI diagnosis in Spain: a single-blind study

Sexually Transmitted Infections, Год журнала: 2024, Номер 100(7), С. 405 - 410

Опубликована: Июль 4, 2024

Sexually transmitted infections (STIs) have markedly increased over the last decade in Spain, calling for prevention and control innovative approaches. While there is evidence indicating effectiveness of self-sampling STI diagnosis, no kits this purpose been authorised Spain.

Язык: Английский

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Acceptability and Usability of Self-Sampling for the Detection of Sexually Transmitted Infections Among Transgender Women: The TransOdara Multicentric Study in Brazil

Sexually Transmitted Diseases, Год журнала: 2024, Номер 51(4), С. 276 - 282

Опубликована: Янв. 10, 2024

Background The effective testing of sexually transmitted infections (STIs) requires sampling from potential infection sites. This study aimed to assess the choice, satisfaction, and performance self-collected samples (SCS) sites for STI among transgender women in Brazil. Methods TransOdara was a multicentric, cross-sectional prevalence conducted 5 Brazilian cities. Using respondent-driven sampling, 1317 18 years or older were recruited. Participants completed interviewer-led questionnaires provided swab multiple (anorectal, oropharyngeal, genital) Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), human papillomavirus (HPV) testing. given choice SCS provider-collected (PCS) at each site. Results Most participants selected anorectal (74.9%; 95% confidence interval [CI], 72.4–77.3) genital (72.7%; CI, 70.2–75.1) sites, whereas fewer chose oropharyngeal (49.8%; 47.0–52.6). For future testing, most expressed preference (72.2%; 69.5–74.7) (70.2%; 67.6–72.7) There no significant difference positive test results CT NG between PCS HPV (penile neovaginal) Conclusions demonstrated high level acceptability usability self-sampling women. A evident comparable those PCS. findings suggest that multisite utilizing self-collection methods as option can be effectively integrated into sexual health services

Язык: Английский

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