Vanderkruik Rachel, Goodman Georgia R, Blyler Abigail, Ott Corilyn, Rivas Alexa, Elopre Latesha, Krakower Doug, Kudroff Kachina, Wise Jenni, Underwood Eric, McDonald Victoria, Campbell Marquetta, Kempf Mirjam-Colette, Psaros Christina
Department of Psychiatry, Massachusetts General Hospital, Boston MA, United States.
Department of Psychiatry, Massachusetts General Hospital, Boston MA, United States; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States; The Fenway Institute, Fenway Health, Boston, MA, United States.
Sex Reprod Healthc. 2024 Dec;42:101043. doi: 10.1016/j.srhc.2024.101043. Epub 2024 Nov 5.
Sexually transmitted infections (STIs), including HIV, are a key contributor to psychological and physical morbidity across the United States (US). African American (AA) women are disproportionately impacted by STIs, particularly in the Deep South of the US. Strong patient-provider communication can help to increase client understanding of STI prevention and treatment options. This study aimed to explore factors influencing effective patient-provider relationships and communication around STIs (including HIV) and sexual health broadly, which will ultimately inform the refinement of a patient-provider communication tool for discussing PrEP as an HIV prevention method.
As part of a larger study focused on PrEP implementation, in-depth, semi-structured qualitative interviews were conducted among cisgender AA women who are PrEP-eligible, both with and without PrEP experience, as well as providers from three federally qualified health centers (FQHCs) and HIV service agencies in Alabama. Data were analyzed using content analysis.
A total of 41 participants enrolled, including 21 clients (n = 6 PrEP experienced; n = 15 PrEP naïve) and 20 providers. Qualitative data were organized across the following domains: meaning of health and sexual health, factors influencing the client-provider relationship, and factors influencing sexual health discussions among clients and providers. Key factors influencing client-provider relationships were organized at client, provider, and clinic levels. Factors impacting sexual health discussions between clients and providers were organized at client, provider, and structural levels.
These interviews identified key determinants of effective client-provider communication pertaining to sexual health among cisgender AA women in the US South who were receiving care at FQHCs and HIV service organizations. Individual, provider, and clinic-level factors were identified that have implications for designing sexual health interventions for cisgender AA women.
包括艾滋病毒在内的性传播感染是美国心理和身体发病的一个关键因素。非裔美国女性受性传播感染的影响尤为严重，特别是在美国南部腹地。良好的医患沟通有助于提高患者对性传播感染预防和治疗选择的理解。本研究旨在探讨影响围绕性传播感染（包括艾滋病毒）和性健康建立有效医患关系及沟通的因素，这最终将为完善用于讨论作为艾滋病毒预防方法的暴露前预防（PrEP）的医患沟通工具提供参考。
作为一项专注于PrEP实施的更大规模研究的一部分，对符合PrEP条件的顺性别非裔美国女性（有和没有PrEP经验）以及阿拉巴马州三家联邦合格健康中心（FQHC）和艾滋病毒服务机构的提供者进行了深入的半结构化定性访谈。使用内容分析法对数据进行分析。
共有41名参与者入组，包括21名患者（6名有PrEP经验；15名无PrEP经验）和20名提供者。定性数据按以下领域进行整理：健康和性健康的含义、影响医患关系的因素以及影响患者与提供者之间性健康讨论的因素。影响医患关系的关键因素按患者、提供者和诊所层面进行整理。影响患者与提供者之间性健康讨论的因素按患者、提供者和结构层面进行整理。
这些访谈确定了在美国南部接受FQHC和艾滋病毒服务组织护理的顺性别非裔美国女性中性健康方面有效医患沟通的关键决定因素。确定了个体、提供者和诊所层面的因素，这些因素对为顺性别非裔美国女性设计性健康干预措施具有启示意义。
