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支持黑人性少数男性健康公平的中性干预措施。

Status-Neutral Interventions to Support Health Equity for Black Sexual Minority Men.

机构信息

Chicago Center for HIV Elimination, Biological Sciences Division, University of Chicago, Chicago, USA.

Department of Medicine, University of Chicago, Chicago, IL, USA.

出版信息

Curr HIV/AIDS Rep. 2022 Aug;19(4):265-280. doi: 10.1007/s11904-022-00610-4. Epub 2022 Jul 6.

Abstract

PURPOSE OF REVIEW

Status-neutral care, a person-centered approach to healthcare not predicated on HIV serostatus, may improve health equity among Black sexual minority men (BSMM). We reviewed current status-neutral, HIV, and Pre-Exposure Prophylaxis (PrEP) interventions, and coded each for social-ecological focus and use of six approaches: (1) person-centered, (2) anti-stigma, (3) social support, (4) the social determinants of health (SDOH), (5) community engagement, and (6) multi-sectoral partnerships.

RECENT FINDINGS

We reviewed 25 studies, of which 3 were status-neutral. Nineteen studies utilized person-centered approaches, with several employing BSMM peers. For SDOH, financial incentives and reducing clinic-level barriers to care improved cascade outcomes. Direct text messaging, anti-stigma, social support, community-engagement, and multi-sectoral partnerships also improved outcomes in some studies. Few status-neutral programs exist and additional research is needed to identify key intervention components and mechanisms of influence. Programs targeting SDOH and multiple social-ecological levels offer promise for providing holistic care to BSMM, while addressing HIV prevention and treatment and health equity.

摘要

综述目的:不以 HIV 血清阳性状况为基础的、对所有人一视同仁的医疗护理方法,即以人为本的医疗方法,可能会提高黑人男同性恋者(BSMM)的健康公平性。我们回顾了目前的无差别护理、HIV 和暴露前预防(PrEP)干预措施,并为每一种干预措施进行了社会生态焦点编码,并使用了六种方法进行编码:(1)以人为本,(2)抗污名化,(3)社会支持,(4)健康的社会决定因素(SDOH),(5)社区参与,和(6)多部门合作。

最新发现:我们回顾了 25 项研究,其中 3 项是无差别的。19 项研究采用了以人为本的方法,其中一些研究采用了 BSMM 的同行。对于 SDOH,经济激励和减少诊所层面的护理障碍可以改善级联结果。直接短信、抗污名化、社会支持、社区参与和多部门合作也在一些研究中改善了结果。目前几乎没有无差别护理计划,需要进一步的研究来确定关键的干预措施组成部分和影响机制。针对 SDOH 和多个社会生态层面的计划为向 BSMM 提供全面护理提供了希望,同时解决了 HIV 预防和治疗以及健康公平问题。

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