Experiences with health care services and HIV testing after sexual assault in cisgender gay, bisexual and other men who have sex with men and transgender people

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2024-03-03 DOI:10.1111/hiv.13629

Romain Palich, Alison J. Rodger, Emily Jay Nicholls, Talen Wright, Phil Samba, Isaac Yen-Hao Chu, Fiona M. Burns, Peter Weatherburn, Roy Trevelion, Leanne McCabe, T. Charles Witzel

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引用次数: 0

Abstract

Objectives

This qualitative sub-study aimed to explore how cisgender gay, bisexual, and other men who have sex with men (cis-GBMSM) and transgender people who reported non-consensual sex (NCS) accessed health care services, what barriers they faced, and how this experience influenced subsequent HIV testing.

Methods

SELPHI is an online randomized controlled trial evaluating both acceptability and efficiency of HIV-self testing among cis-GBMSM and transgender people. Semi-structured interviews were conducted, audio-recorded, transcribed, and analysed through a framework analysis, as a qualitative sub-study. We identified narratives of NCS from interviews and investigated experiences of cis-GBMSM and transgender people accessing health care services following sexual assault.

Results

Of 95 participants, 15 (16%) spontaneously reported NCS. Participants reported a broad range of NCS, including partner's coercive behaviours, non-consensual removal of condoms, and rapes. All feared HIV transmission, leading them to test for HIV, underlining a marked lack of awareness of post-exposure prophylaxis (PEP). Most had negative experiences in communicating with reception staff in sexual health clinics following these incidents. A lack of confidentiality and empathy was described in these situations of psychological distress. Clinic visits were primarily focused on testing for HIV and sexually transmitted infection, and generally no specific psychological support was offered. Getting a negative HIV result was a key step in regaining control for people who experienced NCS.

Conclusions

Sexual health care providers should take care to more fully address the issue of NCS with cis-GBMSM and transgender people when it arises. Recognizing and managing the emotional impact of NCS on affected patients would prevent negative experiences and increase confidence in care.

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同性男同性恋、双性恋和其他男男性行为者以及变性人在遭受性侵犯后对医疗服务和 HIV 检测的体验。

研究目的：这项定性子研究旨在探讨报告了非自愿性行为（NCS）的顺性别男同性恋、双性恋和其他男男性行为者（cis-GBMSM）和变性人是如何获得医疗保健服务的，他们面临哪些障碍，以及这种经历如何影响随后的 HIV 检测：SELPHI是一项在线随机对照试验，旨在评估顺式性行为者和变性者对HIV自我检测的接受程度和效率。作为一项定性子研究，我们进行了半结构化访谈、录音、转录，并通过框架分析进行了分析。我们从访谈中找出了非传染性疾病的叙述，并调查了顺式性别、逆式性别和变性人在遭受性侵犯后获得医疗服务的经历：在 95 名参与者中，有 15 人（16%）自发报告了 NCS。参与者报告了广泛的非性攻击行为，包括伴侣的胁迫行为、非自愿摘除安全套和强奸。所有参与者都担心艾滋病毒的传播，因此进行了艾滋病毒检测，这突出表明他们明显缺乏接触后预防（PEP）的意识。在这些事件发生后，大多数人在与性健康诊所接待人员沟通时都有负面经历。在这些心理困扰的情况下，他们描述了缺乏保密和同情的情况。门诊主要侧重于艾滋病毒和性传播感染的检测，一般不提供具体的心理支持。获得 HIV 阴性结果是经历过 NCS 的人重新获得控制的关键一步：结论：性健康医疗服务提供者应注意在出现非性传播疾病问题时，更全面地解决同性-异性-两性人和变性人的非性传播疾病问题。认识到并处理好非淋菌性阴道炎对受影响患者的情绪影响，可避免负面经历并增强对护理的信心。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.