Identifying factors influencing the uptake of viral illness care in transgender populations
Notice bibliographique
Résumé
Background: Transgender (trans) people globally are disproportionately burdened by viral illnesses, particularly human immunodeficiency virus (HIV), human papillomavirus (HPV), and by related comorbidities due to intersecting psychosocial and structural factors that intensify health inequities and exacerbate barriers to comprehensive and gender-affirming health care. Investigating the factors influencing the uptake of viral illness care in trans populations may improve health outcomes and aid in the development of appropriate training and practice guidelines.Objectives: The first manuscript aims to compare the prevalence of disclosure of trans identity, comfort discussing trans identity and trans-specific health care needs, and negative experiences with HIV physicians, among trans women with HIV in Canada. The second manuscript investigates the acceptability of screenings for cancers associated with HPV in trans populations.Methods: Baseline and cross-sectional data from a subset of 54 trans women with HIV from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) were analyzed. Participants self-reported the disclosure of their trans identity to their family/HIV physicians, their comfort discussing their trans identity and trans-specific health care needs with their family/HIV physicians, and negative experiences with their HIV physicians. The prevalence of disclosure, comfort and negative experiences were reported, and Fisher’s exact tests were performed to determine any association between the gender and training of HIV physicians and self-reported comfort. A scoping review of the literature, adhering to the recommendations of PRISMA, was also performed to answer the research question: “what is the acceptability of screenings for cancers associated with HPV in transgender populations?” The search included MEDLINE, CINAHL, Embase, Web of Science, and Scopus. Articles were reviewed by two independent reviewers, and data was extracted by the primary author to be presented in a narrative summary with accompanying tables.Results: At baseline, of the 54 trans women in CHIWOS, 39 (72.2%) had an HIV care physician defined as a physician who primarily looked after a participant’s HIV medical care in the year preceding. Among this subset, 94.9% had disclosed their trans identity and 82.1% reported feeling comfortable discussing trans-specific health care needs with this physician. Of the 27 (50.0%) who reported having a regular family physician other than their HIV care provider, 92.6% had disclosed their trans identity and 88.9% were comfortable discussing trans-specific health care needs. The most prevalent negative trans-specific experience with HIV physicians reported at baseline was being told by the physician that they did not know enough about trans-related care to provide care (16.7%). Acceptability of cervical and anal cancer screenings varied depending on context and population. Anal cancer screening acceptability in transmasculine and transfeminine populations may be improved by community education, by culturally competent outreach and screening practices, and by encouraging provider recommendations. The acceptability of cervical cancer screening in transmasculine populations was hindered by past negative experiences, pain, and a lack of provider willingness to provide Pap tests and bolstered by the option to self-test and by providing campaigns and screening sites dedicated to transmasculine people. Conclusion: Our results demonstrate the need for comprehensive, trans-specific training for health care providers practicing with trans populations in viral illness settings. The available evidence indicates that gender-affirming viral illness care models may improve retention in HIV care and regular screening for HPV-related cancers in trans populations
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,041 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,003 | 0,004 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».