一种有前途的预防经性途径感染（PrEP）导航干预措施，适用于经历多种综合征健康不平等的跨性别女性和男男性行为者。
A Promising PrEP Navigation Intervention for Transgender Women and Men Who Have Sex with Men Experiencing Multiple Syndemic Health Disparities.
机构信息
Friends Research Institute, Inc., 1419 N. La Brea Ave., Los Angeles, CA, 90028, USA.
Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, Los Angeles, CA, USA.
出版信息
J Community Health. 2019 Dec;44(6):1193-1203. doi: 10.1007/s10900-019-00705-x.
Abstract
Transgender women and MSM experience many stigma-related syndemic conditions that exacerbate HIV incidence and prevalence rates. While PrEP is an effective biomedical intervention to reduce HIV transmission, uptake and adherence of PrEP is low among transgender women and MSM experiencing multiple syndemic health disparities. This study tested the feasibility, acceptability and effectiveness of A.S.K.-PrEP (AssistanceServicesKnowledge-PrEP), a five-session peer navigator program, designed to link transgender women and MSM to PrEP. From September 2016 to March 2018, 187 participants (transgender women = 58; MSM = 129) enrolled. Results demonstrated that approximately 90% of transgender women and MSM were linked to PrEP; MSM linked more quickly [KW χ(1) = 10.9, p < .001]. Most transgender women (80%) and MSM (70%) reported they were still taking PrEP at the 90-day follow-up evaluation. Findings indicated that A.S.K.-PrEP is a promising intervention for PrEP linkage, uptake and preliminary adherence among transgender women and MSM.
摘要
跨性别女性和男男性行为者经历许多与耻辱相关的综合征状况，这些状况加剧了 HIV 的发病率和流行率。虽然 PrEP 是一种有效的生物医学干预措施，可以降低 HIV 的传播，但在经历多种综合征健康差异的跨性别女性和男男性行为者中，PrEP 的使用率和依从率较低。本研究测试了 A.S.K.-PrEP（援助服务知识-PreP）的可行性、可接受性和有效性，这是一个由五节组成的同伴导航员计划，旨在将跨性别女性和男男性行为者与 PreP 联系起来。从 2016 年 9 月到 2018 年 3 月，共有 187 名参与者（跨性别女性=58；男男性行为者=129）入组。结果表明，大约 90%的跨性别女性和男男性行为者都与 PrEP 联系在一起；男男性行为者的联系速度更快[KW χ(1) = 10.9，p <.001]。大多数跨性别女性（80%）和男男性行为者（70%）在 90 天随访评估时报告仍在服用 PrEP。研究结果表明，A.S.K.-PrEP 是一种有前途的干预措施，可以帮助跨性别女性和男男性行为者建立联系、接受 PreP 治疗并初步坚持服用。
相似文献
1
A Promising PrEP Navigation Intervention for Transgender Women and Men Who Have Sex with Men Experiencing Multiple Syndemic Health Disparities.一种有前途的预防经性途径感染（PrEP）导航干预措施，适用于经历多种综合征健康不平等的跨性别女性和男男性行为者。
J Community Health. 2019 Dec;44(6):1193-1203. doi: 10.1007/s10900-019-00705-x.
2
3
HIV prevalence and incidence in a cohort of South African men and transgender women who have sex with men: the Sibanye Methods for Prevention Packages Programme (MP3) project.南非男男性行为者和跨性别女性队列中的 HIV 流行率和发病率：Sibanye 预防包方案（MP3）项目。
J Int AIDS Soc. 2020 Oct;23 Suppl 6(Suppl 6):e25591. doi: 10.1002/jia2.25591.
4
HIV pre-exposure prophylaxis in transgender women: a subgroup analysis of the iPrEx trial.HIV 暴露前预防在跨性别女性中的应用：iPrEx 试验的亚组分析。
Lancet HIV. 2015 Dec;2(12):e512-9. doi: 10.1016/S2352-3018(15)00206-4. Epub 2015 Nov 6.
5
High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project.高暴露前预防药物（PrEP）的使用率和 HIV 感染风险男男性行为者和跨性别女性的早期用药依从性：PrEP Brasil 示范项目。
J Int AIDS Soc. 2017 Apr 6;20(1):21472. doi: 10.7448/IAS.20.1.21472.
6
Same-day initiation of oral pre-exposure prophylaxis among gay, bisexual, and other cisgender men who have sex with men and transgender women in Brazil, Mexico, and Peru (ImPrEP): a prospective, single-arm, open-label, multicentre implementation study.巴西、墨西哥和秘鲁的男同性恋者、双性恋者和其他与男性发生性关系的男性以及跨性别女性中，当日启动口服暴露前预防（PrEP）：一项前瞻性、单臂、开放标签、多中心实施研究。
Lancet HIV. 2023 Feb;10(2):e84-e96. doi: 10.1016/S2352-3018(22)00331-9. Epub 2022 Dec 21.
7
Demonstration project of oral TDF-containing PrEP, administered, once-daily orally to men having sex with men (MSM) and transgender women (TGW) in India: Study protocol.印度男男性行为者和跨性别女性人群口服 TDF 含 PREP 的示范项目：研究方案。
PLoS One. 2023 Jun 23;18(6):e0287454. doi: 10.1371/journal.pone.0287454. eCollection 2023.
8
Disparities in the PrEP continuum for trans women compared to MSM in San Francisco, California: results from population-based cross-sectional behavioural surveillance studies.加利福尼亚州旧金山地区跨性别女性与男男性行为者之间的 HIV 暴露前预防连续性服务差距：基于人群的横断面行为监测研究结果。
J Int AIDS Soc. 2020 Jun;23 Suppl 3(Suppl 3):e25539. doi: 10.1002/jia2.25539.
9
Evaluation of a pre-exposure prophylaxis programme for men who have sex with men and transgender women in Thailand: learning through the HIV prevention cascade lens.评估泰国男男性行为者和跨性别女性的暴露前预防计划：从艾滋病预防阶梯的角度学习。
J Int AIDS Soc. 2020 Jun;23 Suppl 3(Suppl 3):e25540. doi: 10.1002/jia2.25540.
10
Perceived HIV Acquisition Risk and Low Uptake of PrEP Among a Cohort of Transgender Women With PrEP Indication in the Eastern and Southern United States.在美国东部和南部，有一个有接受 PrEP 指征的跨性别女性队列，她们感知到的 HIV 获得风险和 PrEP 的低使用率。
J Acquir Immune Defic Syndr. 2021 Sep 1;88(1):10-18. doi: 10.1097/QAI.0000000000002726.
引用本文的文献
1
Expanding PrEP Access by Embedding Unannounced SNAPS Navigators in High STI Testing Clinical Sites.通过在高性传播感染检测临床场所嵌入未宣布的SNAPS导航员来扩大暴露前预防（PrEP）的可及性。
AIDS Behav. 2025 Sep 8. doi: 10.1007/s10461-025-04868-8.
2
Randomized Controlled Trial Testing an HIV/STI Prevention Intervention Among People Leaving Incarceration Who Were Assigned Male at Birth, Have Sex with Men and A Substance Use Disorder.针对出生时被认定为男性、与男性发生性行为且患有物质使用障碍的刑满释放人员进行的一项关于艾滋病毒/性传播感染预防干预措施的随机对照试验。
AIDS Behav. 2025 Jul 10. doi: 10.1007/s10461-025-04818-4.
3
Strengthening PrEP services at community-based organizations for Latinx men who have sex with men: an implementation science approach.为与男性发生性关系的拉丁裔男性在社区组织中加强暴露前预防服务：一种实施科学方法。
Arch Public Health. 2025 Mar 20;83(1):72. doi: 10.1186/s13690-025-01560-0.
4
Examining Experiences of Gender Identities, Roles, and Relations among Men with Same-Gender Sexual Histories: Implications of Gender Nonconformity on Access to Quality Healthcare in Urban Ghana.审视有同性性经历男性的性别认同、角色及关系体验：加纳城市地区性别非一致性对获得优质医疗保健服务的影响
J Urban Health. 2025 Apr;102(2):413-422. doi: 10.1007/s11524-025-00964-1. Epub 2025 Mar 20.
5
PrEP Disparities Among Transgender Feminine, Transgender Masculine, Nonbinary, and Gender Expansive Youth and Young Adults in the United States.美国跨性别女性、跨性别男性、非二元性别及性别多样化青年和年轻成年人中的暴露前预防差异
AIDS Behav. 2025 Apr;29(4):1136-1157. doi: 10.1007/s10461-024-04590-x. Epub 2025 Jan 31.
6
Mapping Implementation Strategies to Address Barriers to Pre-Exposure Prophylaxis Use Among Women Through POWER Up (Pre-Exposure Prophylaxis Optimization Among Women to Enhance Retention and Uptake): Content Analysis.通过 POWER Up（女性中使用暴露前预防措施的优化以增强保留和接受度）来针对女性使用暴露前预防措施的障碍制定实施策略：内容分析。
JMIR Form Res. 2024 Nov 15;8:e59800. doi: 10.2196/59800.
7
Protocol for a randomized controlled trial with a stepped care approach, utilizing PrEP navigation with and without contingency management, for transgender women and sexual minority men with a substance use disorder: Assistance Services Knowledge-PrEP (A.S.K.-PrEP).一项随机对照试验的方案，采用递进式护理方法，为有物质使用障碍的跨性别女性和性少数男性提供 PrEP 导航，同时使用和不使用意外管理：援助服务知识-PreP（A.S.K.-PreP）。
Addict Sci Clin Pract. 2024 Nov 9;19(1):79. doi: 10.1186/s13722-024-00482-6.
8
Long-Acting Injectable Pre-Exposure Prophylaxis Perceptions and Preferences Among Transgender and Nonbinary Young Adults in the United States.美国跨性别和非二元性别的年轻成年人对长效注射暴露前预防的认知与偏好
Qual Health Res. 2025 Jan;35(1):74-87. doi: 10.1177/10497323241265943. Epub 2024 Aug 2.
9
Barriers and Facilitators Along the PrEP Continuum of Care Among Latinx Sexual Minoritized Men and Transgender Women: A Systematic Review.拉美裔性少数男性和跨性别女性中预防用 PrEP 护理连续体的障碍和促进因素：系统评价。
AIDS Behav. 2024 Nov;28(11):3666-3709. doi: 10.1007/s10461-024-04434-8. Epub 2024 Jul 31.
10
Peer-based interventions to support transgender and gender diverse people's health and healthcare access: A scoping review.基于同伴的干预措施以支持跨性别者和性别多样化人群的健康及医疗服务获取：一项范围综述。
Int J Transgend Health. 2023 Jul 24;25(3):321-351. doi: 10.1080/26895269.2023.2232353. eCollection 2024.
本文引用的文献
1
Outcomes from a Homegrown HIV Prevention Program for Extremely High-risk, Substance-using Men who have Sex with Men with Multiple Health Disparities.一项针对具有多种健康差异、极高风险且使用毒品的男男性行为者的本土艾滋病毒预防项目的成果。
J Gay Lesbian Soc Serv. 2017;29(2):167-181. doi: 10.1080/10538720.2017.1296394. Epub 2017 Mar 27.
2
Trajectories and Predictors of Longitudinal Preexposure Prophylaxis Adherence Among Men Who Have Sex With Men.男男性行为者纵向暴露前预防用药依从性的轨迹和预测因素。
J Infect Dis. 2018 Oct 5;218(10):1551-1559. doi: 10.1093/infdis/jiy368.
3
Efficacy and Safety of Oral TDF-Based Pre-exposure Prophylaxis for Men Who Have Sex With Men: A Systematic Review and Meta-Analysis.基于替诺福韦酯口服暴露前预防对男男性行为者的疗效和安全性：一项系统评价和荟萃分析。
Front Pharmacol. 2018 Sep 4;9:799. doi: 10.3389/fphar.2018.00799. eCollection 2018.
4
Theory-Based Text-Messaging to Reduce Methamphetamine Use and HIV Sexual Risk Behaviors Among Men Who Have Sex with Men: Automated Unidirectional Delivery Outperforms Bidirectional Peer Interactive Delivery.基于理论的短信干预减少男男性行为者的冰毒使用和 HIV 性风险行为：自动化单向传递优于双向同伴互动传递。
AIDS Behav. 2019 Jan;23(1):37-47. doi: 10.1007/s10461-018-2225-z.
5
Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature.通过多层次干预措施改善 PrEP 的实施：文献综述。
AIDS Behav. 2018 Nov;22(11):3681-3691. doi: 10.1007/s10461-018-2184-4.
6
Health Disparities, Risk Behaviors and Healthcare Utilization Among Transgender Women in Los Angeles County: A Comparison from 1998-1999 to 2015-2016.洛杉矶县跨性别女性的健康差异、风险行为和医疗保健利用：1998-1999 年与 2015-2016 年的比较。
AIDS Behav. 2018 Aug;22(8):2524-2533. doi: 10.1007/s10461-018-2165-7.
7
Maximizing the Benefits of HIV Preexposure Prophylaxis.最大化暴露前预防（PrEP）对HIV的益处。
Top Antivir Med. 2018 Apr;25(4):138-142.
8
Barriers and Facilitators to Oral PrEP Use Among Transgender Women in New York City.在纽约市的跨性别女性中，使用口服 PrEP 的障碍和促进因素。
AIDS Behav. 2018 Nov;22(11):3627-3636. doi: 10.1007/s10461-018-2102-9.
9
Exploring transgender legal name change as a potential structural intervention for mitigating social determinants of health among transgender women of color.探索跨性别者合法更改姓名，作为减轻有色人种跨性别女性健康的社会决定因素的一种潜在结构性干预措施。
Sex Res Social Policy. 2018 Mar;15(1):25-33. doi: 10.1007/s13178-017-0289-6. Epub 2017 May 18.
10
Amplifying the Population Health Benefits of PrEP for HIV Prevention.扩大暴露前预防（PrEP）对预防艾滋病毒的人群健康益处。
J Infect Dis. 2018 Apr 23;217(10):1509-1511. doi: 10.1093/infdis/jiy045.
Zotero 插件