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影响美国跨性别女性使用长效注射用卡替拉韦的可及性和接受度的提供者因素:定性研究结果。

Provider Factors Likely to Impact Access and Uptake of Long-Acting Injectable Cabotegravir for Transgender Women in the United States: Results of a Qualitative Study.

机构信息

Christine Tagliaferri Rael, PhD, is an Assistant Professor in the University of Colorado College of Nursing, Aurora, Colorado, USA. Doyel Das, BS, is an MPH Student in the Columbia University Mailman School of Public Health, New York, New York, USA. Jonathan Porter, MPH, was an MPH Student in the Columbia University Mailman School of Public Health, New York, New York, USA, and a Professional Research Assistant in the University of Colorado College of Nursing, Aurora, Colorado, USA. He is currently a Research Consultant, Optem Serve Consulting/The Lewin Group, New York, New York, USA. Javier Lopez-Ríos, PhD, MPH is an Assistant Professor in the Dornsife School of Public Health at Drexel University, Philadelphia, Philadelphia, USA. Elena Abascal, DNP, NP, was a DNP student at the Columbia University School of Nursing, New York, New York, USA, and a Clinical Research Nurse at the New York State Psychiatric Institute (NYSPI), New York, New York, USA. She is currently a Nurse Practitioner, Columbia University Irving Medical Center/New York Presbyterian Morgan Stanley Children's Hospital, New York, New York, USA. Curtis Dolezal, PhD is an Assistant Clinical Professor in the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute/Columbia University Psychiatry, New York, New York, USA. Michael P. Vaughn, PhD, MPH was a Postdoctoral Research Fellow in the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute/Columbia University Psychiatry, New York, New York, USA. He is currently the Research Operations Lead (Experience Design), Capital One Bank, New York, New York, USA. Pilar Giffenig, DNP, MSN, APRN, FNP-C, was a DNP student at the Columbia University School of Nursing, New York, New York, USA, and a Clinical Research Nurse at the New York State Psychiatric Institute, New York, New York, USA. She is currently a Nurse Practitioner, RemoteFocus, New York, New York, USA. Jasmine M. Lopez, BS, is a Research Assistant in the HIV Center for Clinical and Behavioral Studies at NYSPI/Columbia University Psychiatry, New York, New York, USA. Samantha Stonbraker, PhD, MPH, RN, is an Assistant Professor in the University of Colorado College of Nursing, Aurora, Colorado, USA. Christina Sun, PhD, is an Associate Professor in the University of Colorado Collee of Nursing, Aurora, Colorado, USA. Roque Anthony Velasco, MS, NP, is a PhD Student in the University of Colorado College of Nursing, Aurora, Colorado, USA. Leandra Bitterfeld, RN, is a PhD Student in the University of Colorado College of Nursing, Aurora, CO, USA. Walter O. Bockting, PhD, is a Professor and Co-Chief of the Gender Health and Sexuality Area at New York State Psychiatric Institute/Columbia University, New York, New York, USA, and a Professor in the Columbia University School of Nursing, New York, New York, USA. Jose Bauermeister, PhD, MPH, FSBM, is a Professor in the School of Nursing and School of Medicine and the Albert M Greenfield University Professor of Human Relations at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

J Assoc Nurses AIDS Care. 2024;35(5):437-449. doi: 10.1097/JNC.0000000000000488. Epub 2024 Aug 13.


DOI:10.1097/JNC.0000000000000488
PMID:39137316
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11361836/
Abstract

Long-acting injectable cabotegravir (CAB-LA) was US Food and Drug Administration-approved in 2021. However, little is known about providers' CAB-LA knowledge, attitudes, challenges, and prescribing preferences for transgender women patients. Understanding this is critical to developing new pre-exposure prophylaxis (PrEP) interventions tailored to transgender women. We conducted 45-min, in-depth Zoom interviews (IDIs) with United States-based health care providers who prescribe PrEP to transgender women. IDIs focused on providers' CAB-LA knowledge/acceptability, willingness to prescribe CAB-LA to transgender women, potential challenges, and solutions to mitigate challenges. Providers ( N = 17) had a mean age of 43 years, and 35.4% ( n = 6) identified as people of color. Most ( n = 12) had basic knowledge of CAB-LA but wanted additional training. All participants found CAB-LA acceptable and were willing to prescribe. Most ( n = 11) anticipated minimal challenges to implementation. Others ( n = 4) reported potential issues, including logistical/scheduling concerns that impede CAB-LA integration and staffing concerns. Many providers expressed support for self-injection ( n = 13) and injections at "drop-in" clinics ( n = 8) to overcome challenges.

摘要

长效注射型卡替拉韦(CAB-LA)于 2021 年获得美国食品和药物管理局批准。然而,对于医疗服务提供者在为跨性别女性患者开处方时,对 CAB-LA 的了解、态度、挑战和偏好知之甚少。了解这些问题对于开发新的针对跨性别女性的暴露前预防(PrEP)干预措施至关重要。我们对在美国为跨性别女性开 PrEP 处方的医疗服务提供者进行了 45 分钟的深入 Zoom 访谈(IDIs)。IDIs 主要关注提供者对 CAB-LA 的了解/可接受性、为跨性别女性开 CAB-LA 的意愿、潜在挑战以及缓解挑战的解决方案。提供者(N=17)的平均年龄为 43 岁,35.4%(n=6)为有色人种。大多数(n=12)对 CAB-LA 有基本了解,但希望接受额外培训。所有参与者都认为 CAB-LA 是可以接受的,并愿意开处方。大多数(n=11)预计实施过程中几乎没有挑战。其他人(n=4)报告了潜在问题,包括影响 CAB-LA 整合的后勤/调度问题和人员配备问题。许多提供者表示支持自我注射(n=13)和在“随到随诊”诊所进行注射(n=8),以克服挑战。

相似文献

[1]
Provider Factors Likely to Impact Access and Uptake of Long-Acting Injectable Cabotegravir for Transgender Women in the United States: Results of a Qualitative Study.

J Assoc Nurses AIDS Care.

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
HIV incidence and mortality in transgender women in the eastern and southern USA: a multisite cohort study.

Lancet HIV. 2023-5

[2]
Prevention-effective adherence trajectories among transgender women indicated for PrEP in the United States: a prospective cohort study.

Ann Epidemiol. 2022-6

[3]
Cabotegravir for HIV Prevention in Cisgender Men and Transgender Women.

N Engl J Med. 2021-8-12

[4]
Transgender Women's Barriers, Facilitators, and Preferences on Tailored Injection Delivery Strategies to Administer Long-Acting Injectable Cabotegravir (CAB-LA) for HIV Pre-exposure Prophylaxis (PrEP).

AIDS Behav. 2021-12

[5]
Characterization of Human Immunodeficiency Virus (HIV) Infection in Cisgender Men and Transgender Women Who Have Sex With Men Receiving Injectable Cabotegravir for HIV Prevention: HPTN 083.

J Infect Dis. 2021-11-16

[6]
Assessing the Role of Long-Acting Cabotegravir Preexposure Prophylaxis of Human Immunodeficiency Virus: Opportunities and Aspirations.

J Infect Dis. 2021-1-4

[7]
Understanding the Acceptability of Subdermal Implants as a Possible New HIV Prevention Method: Multi-Stage Mixed Methods Study.

J Med Internet Res. 2020-7-27

[8]
Health Care Provider Barriers to HIV Pre-Exposure Prophylaxis in the United States: A Systematic Review.

AIDS Patient Care STDS. 2020-2-28

[9]
Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers.

Prev Med Rep. 2019-10-21

[10]
Transgender Women's Concerns and Preferences on Potential Future Long-Acting Biomedical HIV Prevention Strategies: The Case of Injections and Implanted Medication Delivery Devices (IMDDs).

AIDS Behav. 2020-5

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