HIV testing among transgender and other gender diverse persons in the United States: A scoping review.

Jake Anders, Anthony Freeman, Baichun Hou, Philippa Sone, Jasmine Lopez-Phelan, Patrick Padgen, Rebecca Giguere, Cam Gowdicott, Shima Ge, Alyson Clarke, Cristina Herrera, Zoe Edelstein, Theo G M Sandfort
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Abstract

Background: An overview of existing research on HIV testing among transgender and other gender diverse (TGD) populations in the United States is missing, while critical for informing future interventions and research.

Methods: Employing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, three databases (CINAHL, PubMed/Medline, PsycINFO) were searched for studies reporting in English on HIV testing behavior that focused on or included TGD persons, published in the last decade (February 2, 2013 to February 2, 2023). Twenty-six studies were included and extracted using Covidence.

Results: Four topics regarding HIV testing among TGD persons were identified: prevalence of HIV testing compared with cisgender persons, testing frequency and associated factors among TGD persons, barriers and facilitators to HIV testing experienced by TGD persons, and testing modalities. TGD persons seemed more likely to have been tested for HIV compared to cisgender persons, but less frequent compared to cisgender men who have sex with men. Barriers to testing included availability, confidentiality concerns, and negative interactions with providers. Social support and gender-affirming care were seen as facilitators. Self-testing, although not common, was acceptable and preferred when available. The conceptualizations and operationalizations of the term transgender varied markedly across studies.

Conclusions: Our understanding of HIV testing practices in TGD populations is limited and shows serious gaps. Research on repeat testing is needed to enhance HIV prevention and care among TGD populations. Future research might benefit from theory-driven approaches and from involving TGD persons in the design and implementation of studies to ensure relevance and efficacy.

美国跨性别者和其他性别差异者的艾滋病毒检测:范围审查。
背景:对美国跨性别者和其他性别多样性(TGD)人群中HIV检测的现有研究的概述是缺失的,而这对未来的干预和研究至关重要。方法:采用首选报告项目进行系统评价和荟萃分析,检索三个数据库(CINAHL, PubMed/Medline, PsycINFO),检索近十年(2013年2月2日至2023年2月2日)发表的以英语报道HIV检测行为的研究,这些研究关注或包括TGD患者。纳入26项研究并使用covid - ence进行提取。结果:确定了TGD人群中HIV检测的四个主题:与顺性人群相比HIV检测的流行程度,TGD人群中HIV检测的频率及其相关因素,TGD人群中HIV检测的障碍和促进因素,以及检测方式。与顺性人相比,TGD人似乎更有可能接受艾滋病毒检测,但与同性性行为的顺性人相比,检测频率较低。测试的障碍包括可用性、保密性问题以及与供应商的负面交互。社会支持和性别肯定护理被视为促进因素。自我测试虽然不常见,但在可用的情况下是可以接受和首选的。跨性别者一词的概念化和操作化在不同的研究中有很大的不同。结论:我们对TGD人群的HIV检测实践了解有限,存在严重差距。需要对重复检测进行研究,以加强TGD人群的艾滋病毒预防和护理。未来的研究可能受益于理论驱动的方法,以及让TGD人员参与研究的设计和实施,以确保相关性和有效性。
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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