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采用社会生态模型和脆弱性理论框架对男男性行为者和跨性别女性的 HIV 检测中的健康促进进行映射证据:范围综述。

Mapping evidence on health promotion in HIV testing among men who have sex with men and transgender women using the social-ecological model and the vulnerability theoretical framework: a scoping review.

机构信息

Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Basílio da Gama Street, Salvador, BA, 40110-040, Brazil.

Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), 2555 Silveira Martins Street, Salvador, BA, 41150000, Brazil.

出版信息

BMC Public Health. 2023 Oct 7;23(1):1946. doi: 10.1186/s12889-023-16860-9.

Abstract

This study aimed to map the scientific evidence on health promotion in human immunodeficiency virus) HIV testing among men who have sex with men (MSM) and transgender women (TGW) based on the social-ecological model (i.e., individual, organizational and social levels) and the theoretical framework of vulnerability (i.e., individual, social, and programmatic levels). The reviewed studies indicated several barriers to accessing HIV testing (e.g., economic, structural, and bureaucratic) and demonstrated the potential for community approaches to promote greater access to HIV testing and minimize the stigma and discrimination associated with HIV testing, primarily through community leadership and social support networks. The socio-ecological model of health promotion and the vulnerability approach have the potential to contribute to improving HIV testing services by balancing the technical and political power of health services and providers with community participation while considering the social contexts. Therefore, there is a need for reflection on health promotion policies and programs aimed at expanding access to HIV testing among MSM and TGW through interventions that consider the social contexts and cultural perspectives. Moreover, inter-sectoral strategies aimed at improving living conditions and access to fundamental resources for maintaining health and well-being should be considered.

摘要

本研究旨在根据社会生态模型(即个体、组织和社会层面)和脆弱性理论框架(即个体、社会和方案层面),绘制男男性行为者和跨性别女性在人类免疫缺陷病毒(HIV)检测方面的健康促进科学证据。综述研究表明,获取 HIV 检测存在多种障碍(如经济、结构和官僚障碍),并展示了社区方法在促进更多人获得 HIV 检测以及减少与 HIV 检测相关的污名和歧视方面的潜力,主要通过社区领导和社会支持网络。健康促进的社会生态模型和脆弱性方法有可能通过平衡卫生服务和提供者的技术和政治权力与社区参与,同时考虑社会背景,来改善 HIV 检测服务。因此,有必要反思旨在通过考虑社会背景和文化观点的干预措施来扩大男男性行为者和跨性别女性获得 HIV 检测的健康促进政策和方案。此外,应考虑采取跨部门战略,改善生活条件和获得维持健康和福祉的基本资源的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e54d/10559455/49f8cb174359/12889_2023_16860_Fig1_HTML.jpg

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