使用综合干预措施改善黑人顺性别和跨性别女性的健康结果：“黑人女性优先”倡议的研究结果。

Using Bundled Interventions to Improve Health Outcomes for Black Cisgender and Transgender Women: Findings From the Black Women First Initiative.

作者信息

Rajabiun Serena, Heath Corliss D, Spencer LaShonda Y, McClair Tracy L, Cabral Howard J, Chen Clara A, Dugas Julianne N, Dakin Andrea, Downes Alicia, McKinney-Prupis Erin, Scott Jennifer, Lewis-Chery Shakeila, Walter Angela Wangari, Cuca Yvette P

机构信息

Serena Rajabiun and Angela Wangari Walter are with the Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, MA. Corliss D. Heath and Tracy L. McClair are with the HIV/AIDS Bureau, Health Resources & Services Administration, Rockville, MD. LaShonda Y. Spencer is with the Charles R. Drew University of Medicine and Science, Los Angeles, CA. Howard J. Cabral is with the Department of Biostatistics, Boston University School of Public Health, Boston, MA. Clara A. Chen and Julianne N. Dugas are with the Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA. Andrea Dakin is with the AIDS Foundation Chicago, Chicago, IL. Alicia Downes is with AIDS United, Washington, DC. Erin McKinney-Prupis is with the Alliance for Positive Change, New York, NY. Jennifer Scott is with Abounding Prosperity, Inc., Dallas, TX. Shakeila Lewis-Chery is with the Ponce de Leon Center, Grady Health System, Atlanta, GA. Yvette P. Cuca is with the School of Nursing, University of California, San Francisco, CA.

出版信息

Am J Public Health. 2025 Apr;115(S1):S46-S56. doi: 10.2105/AJPH.2025.308019.

DOI:10.2105/AJPH.2025.308019

PMID:40138641

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11947488/

Abstract

To examine the effects of replicating a bundled package of evidence-informed interventions on social determinants, HIV health outcomes, and health-related quality of life (HRQoL) for 697 Black cisgender and transgender women with HIV across 12 US sites from 2021 to 2023. Women participated in a minimum of 2 interventions. We collected self-reported HRQoL and social determinants via interview at baseline, 6 months, and 12 months. We collected retention in care and viral suppression via medical chart review. We examined effects by gender identity and type and number of bundled interventions received. In the 12-month postenrollment period, 85.0% of women reached viral suppression and 74.3% were retained in care. Social determinants and HRQoL improved over time. Transgender women had significantly lower odds of retention in care compared with cisgender women (adjusted odds ratio = 0.85; 95% confidence interval = 0.77, 0.93) but an overall higher physical HRQoL score (46.8 vs 40.8). Viral suppression and mental HRQoL did not differ by gender identity. Using a bundled intervention is a promising approach to reach and provide culturally relevant care for Black women with HIV. (. 2025;115(S1):S46-S56. https://doi.org/10.2105/AJPH.2025.308019).

摘要

为研究在2021年至2023年期间，对美国12个地点的697名感染HIV的黑人顺性别和跨性别女性复制一整套循证干预措施，对社会决定因素、HIV健康结果以及健康相关生活质量（HRQoL）的影响。这些女性至少参与了2项干预措施。我们通过在基线、6个月和12个月时进行访谈收集自我报告的HRQoL和社会决定因素。我们通过查阅病历收集护理留存率和病毒抑制情况。我们按性别认同以及所接受的综合干预措施的类型和数量来研究影响。在入组后的12个月期间，85.0%的女性实现了病毒抑制，74.3%的女性保持在护理中。社会决定因素和HRQoL随时间有所改善。与顺性别女性相比，跨性别女性的护理留存几率显著更低（调整后的优势比 = 0.85；95%置信区间 = 0.77, 0.93），但总体身体HRQoL得分更高（46.8对40.8）。病毒抑制和心理HRQoL在性别认同方面没有差异。采用综合干预措施是一种有前景的方法，可为感染HIV的黑人女性提供可及且具有文化相关性的护理。（. 2025;115(S1):S46 - S56. https://doi.org/10.2105/AJPH.2025.308019）