Lacombe-Duncan Ashley, Logie Carmen H, Persad Yasmeen, Leblanc Gabrielle, Nation Kelendria, Kia Hannah, Scheim Ayden I, Lyons Tara, Loutfy Mona
School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
Women's College Hospital, Toronto, Ontario, Canada.
BMJ Open. 2020 Jul 31;10(7):e034144. doi: 10.1136/bmjopen-2019-034144.
Educational workshops are a promising strategy to increase healthcare providers' ability to provide gender-affirming care for transgender (trans) people. This strategy may also reduce healthcare providers' stigma towards trans people and people living with HIV. There is less evidence, however, of educational workshops that address HIV prevention and care among trans women. This protocol details development and pilot testing of the Transgender Education for Affirmative and Competent HIV and Healthcare intervention that aims to increase gender-affirming HIV care knowledge and perceived competency, and to reduce negative attitudes/biases, among providers.
This community-based research (CBR) project involves intervention development and implementation of a non-randomised multisite pilot study with pre-post test design. First, we conducted a qualitative formative phase involving focus groups with 30 trans women and individual interviews with 12 providers to understand HIV care access barriers for trans women and elicit feedback on a proposed workshop. Second, we will pilot test the intervention with 90-150 providers (n=30-50×3 in-person settings). For pilot studies, primary outcomes include feasibility (eg, completion rate) and acceptability (eg, workshop satisfaction). Secondary preintervention and postintervention outcomes, assessed directly preceding and following the workshop, include perceived competency, attitudes/biases towards trans women with HIV, and knowledge needed to provide gender-affirming HIV care. Primary outcomes will be summarised as frequencies and proportions (categorical variables). We will conduct paired-sample t-tests to explore the direction of preintervention and postintervention differences for secondary outcomes.
This study has been approved by the University of Toronto HIV Research Ethics Board (Protocol Number: 00036238). Study findings will be disseminated through community forums with trans women and service providers; manuscripts submitted to peer reviewed journals; and conferences. Findings will inform a larger CBR research agenda to remove barriers to engagement in HIV prevention/care among trans women across Canada.
NCT04096053; Pre-results.
教育研讨会是一种很有前景的策略，可提高医疗服务提供者为跨性别者提供性别肯定性护理的能力。这一策略还可能减少医疗服务提供者对跨性别者和艾滋病毒感染者的污名化。然而，针对跨性别女性的艾滋病毒预防和护理的教育研讨会的证据较少。本方案详细介绍了“跨性别者积极与胜任的艾滋病毒及医疗保健教育”干预措施的开发和试点测试，该干预措施旨在提高医疗服务提供者对性别肯定性艾滋病毒护理的知识和感知能力，并减少负面态度/偏见。
这个基于社区的研究（CBR）项目包括干预措施的开发和实施一项采用前后测试设计的非随机多地点试点研究。首先，我们进行了一个定性的形成阶段，包括与30名跨性别女性进行焦点小组讨论以及与12名医疗服务提供者进行个人访谈，以了解跨性别女性获得艾滋病毒护理的障碍，并就拟议的研讨会征求反馈意见。其次，我们将对90 - 150名医疗服务提供者（在3个现场环境中，每组30 - 50人）进行干预措施的试点测试。对于试点研究，主要结果包括可行性（如完成率）和可接受性（如研讨会满意度）。在研讨会前后直接评估的次要干预前和干预后结果包括感知能力、对感染艾滋病毒的跨性别女性的态度/偏见以及提供性别肯定性艾滋病毒护理所需的知识。主要结果将总结为频率和比例（分类变量）。我们将进行配对样本t检验，以探讨次要结果在干预前和干预后的差异方向。
本研究已获得多伦多大学艾滋病毒研究伦理委员会批准（方案编号：00036238）。研究结果将通过与跨性别女性和服务提供者的社区论坛、提交给同行评审期刊的手稿以及会议进行传播。研究结果将为一个更大的基于社区的研究议程提供信息，以消除加拿大跨性别女性参与艾滋病毒预防/护理的障碍。
NCT04096053；预结果。
