Hines Dana D, Draucker Claire Burke, Habermann Barbara
J Assoc Nurses AIDS Care. 2017 Sep-Oct;28(5):723-736. doi: 10.1016/j.jana.2017.05.003. Epub 2017 May 11.
Trans women in the United States are disproportionately affected by HIV infection. To improve HIV services for this population, more information is needed about their experiences in early stages of the HIV Care Continuum. Trans women in states such as Indiana, which has moderate HIV incidence but little public health investment in HIV prevention and treatment, experience special challenges. Our qualitative descriptive study describes the circumstances influencing HIV testing and entry to care by 18 trans women living with HIV in Central Indiana. In-depth interviews regarding participants' HIV care experiences were analyzed using standard content analysis. Participants discussed three main topics: (a) HIV testing circumstances, (b) facilitators and barriers to entering care, and (c) motivators for entering care after a delay. Findings indicate that social relationships play a significant role in trans women's care experiences and that stigma, discrimination, and adverse life circumstance are powerful deterrents to care. Practice and policy implications are discussed.
美国的跨性别女性受艾滋病毒感染的影响尤为严重。为改善针对这一人群的艾滋病毒服务，需要更多关于她们在艾滋病毒护理连续统一体早期阶段经历的信息。在印第安纳州等艾滋病毒发病率中等但在艾滋病毒预防和治疗方面公共卫生投资较少的州，跨性别女性面临特殊挑战。我们的定性描述性研究描述了影响印第安纳州中部18名感染艾滋病毒的跨性别女性进行艾滋病毒检测和开始接受护理的情况。使用标准内容分析法对参与者关于艾滋病毒护理经历的深入访谈进行了分析。参与者讨论了三个主要话题：(a)艾滋病毒检测情况，(b)开始接受护理的促进因素和障碍，以及(c)延迟后开始接受护理的动机。研究结果表明，社会关系在跨性别女性的护理经历中起着重要作用，耻辱感、歧视和不利的生活环境是接受护理的强大阻碍。文中讨论了实践和政策方面的影响。
