Dakpui Henry Delali, Shamrock Osman Wumpini, Aidoo-Frimpong Gloria, Zigah Edem Yaw, Kofi Agbemedu George Rudolph, Ahmed Abdallah, Osman Umar, Haruna Aliyu, Abu-Ba'are Gamji Rabiu
Behavioral, Sexual, and Global Health Lab, North Legon, Accra, Ghana.
Behavioral, Sexual, and Global Health Lab, School of Nursing, University of Rochester, Rochester, New York, United States of America.
PLOS Glob Public Health. 2024 Dec 2;4(12):e0003980. doi: 10.1371/journal.pgph.0003980. eCollection 2024.
Achieving the UNAIDS 90-90-90 targets hinges on identifying and engaging individuals with HIV in care, requiring 90% of those infected to be diagnosed, initiated on ART, and achieving viral suppression. Despite this imperative, HIV testing services as well as research in Ghana often overlook the unique experiences of transgender women in urban slums, impacting their engagement with care. Using the gender affirmative model lens, this study reports the HIV testing experiences of trans women in Ghanaian slums, highlighting how the healthcare environment, counseling, and healthcare provider attitudes shape these experiences. The study used a qualitative descriptive interview design with 20 trans women aged 18 to 31 from urban slums in Greater Accra Metropolitan Area, Ghana. Participants were recruited through purposive and snowball sampling. Data were collected via face-to-face interviews, transcribed, and analyzed using NVivo, with results presented in categories and subcategories. Two main categories emerged from our data analysis: 1) Positive Experiences with HIV Testing, and 2) Negative Experiences with HIV Testing. Positive experiences with HIV testing among trans women in Ghanaian slums included a welcoming environment at healthcare facilities, supportive counseling, and relatability with HIV-positive nurses. Negative experiences were characterized by fear and anxiety during testing, often intensified by healthcare worker attitudes, including unwelcoming behaviors and judgmental body language, especially in facilities that are not key population friendly. These categories provided a framework for understanding the varied experiences of trans women in Ghanaian slums regarding HIV testing. The study highlights the urgent need for Ghanaian slum healthcare facilities to address discrimination against trans women by creating inclusive, supportive environments. It stresses the importance of using a gender-affirmative approach to improve HIV testing and health outcomes for trans women. Policymakers and healthcare providers must focus on training, inclusive care, and cultural competence to reduce health disparities for this population.
实现联合国艾滋病规划署的90-90-90目标取决于识别并促使感染艾滋病毒的人接受治疗，这要求90%的感染者得到诊断、开始接受抗逆转录病毒治疗并实现病毒抑制。尽管有这一迫切需求，但加纳的艾滋病毒检测服务以及相关研究往往忽视了城市贫民窟中跨性别女性的独特经历，影响了她们接受治疗的情况。本研究运用性别肯定模式视角，报告了加纳贫民窟中跨性别女性的艾滋病毒检测经历，突出了医疗环境、咨询服务以及医疗服务提供者的态度如何塑造了这些经历。该研究采用定性描述性访谈设计，对来自加纳大阿克拉都会区城市贫民窟的20名年龄在18至31岁之间的跨性别女性进行了访谈。参与者通过目的抽样和滚雪球抽样的方式招募。数据通过面对面访谈收集、转录，并使用NVivo进行分析，结果以类别和子类别呈现。我们的数据分析得出了两个主要类别：1）艾滋病毒检测的积极经历，以及2）艾滋病毒检测的消极经历。加纳贫民窟跨性别女性在艾滋病毒检测方面的积极经历包括医疗机构的友好环境、支持性的咨询服务以及与艾滋病毒呈阳性护士的共鸣。消极经历的特点是检测期间的恐惧和焦虑，医护人员的态度往往会加剧这种情绪，包括不友好的行为和评判性的肢体语言，尤其是在对重点人群不友好的机构中。这些类别为理解加纳贫民窟跨性别女性在艾滋病毒检测方面的不同经历提供了一个框架。该研究强调，加纳贫民窟的医疗机构迫切需要通过营造包容、支持性的环境来解决对跨性别女性的歧视问题。它强调了采用性别肯定方法来改善跨性别女性艾滋病毒检测和健康结果的重要性。政策制定者和医疗服务提供者必须专注于培训、包容性护理和文化能力，以减少这一人群的健康差距。
