社会和结构性障碍对加拿大温哥华都会区艾滋病毒感染者获得初级保健的影响：一项纵向队列研究。
Social and Structural Barriers to Primary Care Access Among Women Living With HIV in Metro Vancouver, Canada: A Longitudinal Cohort Study.
机构信息
Kathleen N. Deering, PhD, is an Assistant Professor, Division of AIDS, Department of Medicine, Faculty of Medicine, University of British Columbia and Research Scientist at the Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada.
Louise Chong, MD, is a Family Medicine Resident, University of Calgary, Calgary, Alberta, Canada.
出版信息
J Assoc Nurses AIDS Care. 2021;32(5):548-560. doi: 10.1097/JNC.0000000000000234.
This study examines correlates of being unable to access primary care in the past 6 months among cisgender (cis) and trans women living with HIV (WLWH). Data were drawn from a longitudinal community-based cohort study of WLWH (ages 14+) in Metro Vancouver, Canada (2014-2017). Of 291 participants contributing 914 observations, 15.5% reported being unable to access primary care at baseline. In multivariable analysis, increased odds of being unable to access primary care was associated with (a) having im/migrated to Canada, and, in the past 6 months, (b) identifying as gender minority, (c) experiencing physical or sexual violence, (d) having suicidal ideation or attempts. Decreased odds were associated with recently accessing HIV-specific resources. Our findings suggest that primary health care for WLWH should address high levels of violence and mental health conditions as well as barriers to services for gender minority and im/migrant WLWH.
本研究调查了过去 6 个月中 cisgender（顺性别）和 HIV 阳性跨性别女性（WLWH）无法获得初级保健的相关因素。数据来自加拿大温哥华市（2014-2017 年）基于社区的 WLWH 纵向队列研究。在 291 名参与者中，有 914 名参与者提供了 914 个观察结果，其中 15.5%的参与者在基线时表示无法获得初级保健。在多变量分析中，无法获得初级保健的可能性与以下因素相关：(a)移民到加拿大，以及(b)在过去 6 个月中，(c)自我认同为性别少数群体，(d)经历身体或性暴力，(e)有自杀意念或企图。获得 HIV 特定资源的可能性较低。我们的研究结果表明，WLWH 的初级卫生保健应解决高暴力和心理健康状况以及性别少数群体和移民 WLWH 获得服务的障碍。
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