Gender-based differences in non-HIV STI testing among sexually active transgender and nonbinary persons: Bridging gaps in STI research

性活跃的跨性别者和非二元性别者中非艾滋病毒性传播感染检测中基于性别的差异：弥合性传播感染研究中的差距

• 批准号: 10334537
• 负责人: Shanna Katz Kattari
• 金额: $ 7.8万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-01 至 2023-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10334537
• 关键词: Address; Affect; Birth; Centers for Disease Control and Prevention (U.S.); Clinic; Data; Direct Costs; Discrimination; Ecology; Ethnic Origin; Female; Focus Groups; Future; Gender; Gender Identity; General Population; Goals; HIV; HIV risk; Health; Health Care Costs; Health Insurance; Health Services Accessibility; Health Surveys; Healthcare Systems; Human immunodeficiency virus test; Individual; Intervention; Knowledge; Label; Left; Literature; Malignant Neoplasms; Medical; Methods; Michigan; Morbidity - disease rate; Outcome; Participant; Persons; Population; Prevalence; Provider; Public Health; Publishing; Qualitative Research; Race; Recording of previous events; Reporting; Reproductive Health; Research; Respondent; Risk; STI prevention; Sexually Transmitted Diseases; Surveys; Testing; Time; United States; Woman; Women' s Group; base; community transmission; hormone therapy; infection burden; infection rate; male; men; minority stress; programs; sex; sexually active; social; social expectations; social stigma; social structure; testing uptake; theories; transgender; transgender men; transgender women; transmission process

PROJECT ABSTRACT Research suggests that transgender (trans) populations, a diverse group of persons whose gender identity and/or expression differ from societal expectations associated with their sex labelled at-birth, have high rates of non-HIV sexually transmitted infections (STIs). Untreated non- HIV STIs can contribute to negative health outcomes and community transmission. Therefore, access to non-HIV STI testing is of critical importance to mitigate morbidity and promote public health. Of the published research focused on non-HIV STI testing among trans people, studies are limited in population focus (almost exclusively trans women). Notably absent are nonbinary persons (those who do not identify exclusively as men or women), though this group comprises 1/3 of all trans people in the U.S. Scant literature has examined gender-based differences in non- HIV STI testing among trans and nonbinary (TNB) populations. Moreover, information gaps also exist regarding barriers and facilitators to non-HIV STI testing among TNB populations, and how these barriers and facilitators may differ by gender. To address these gaps, our team will examine whether sexually active TNB populations are characterized by gender-based differences (trans women/trans men/nonbinary people) in their rates of non-HIV STI testing and barriers and facilitators to non-HIV STI testing. We will conduct an explanatory sequential mixed-methods study using secondary quantitative data from the 2018 Michigan Trans Health Survey (MTHS) and a primary qualitative study of TNB persons using online focus groups. First, we will determine gender-based differences in a) rates of lifetime non-HIV STI testing history (never, ever) and b) time since last non-HIV STI test (never, past year, 1-5 years, >5 years) among sexually active TNB persons. Then, informed by an integrated conceptual framework drawing on social ecology, minority stress, and gender affirmation, we will examine whether individual (e.g., race/ethnicity), medical (e.g., hormone therapy); social (e.g., provider discrimination based on gender identity); and structural (e.g., clinic gender affirmation) factors are uniquely associated with lifetime non- HIV STI testing history, and whether gender identity moderates the association between lifetime non-HIV STI testing history and statistically significantly associated independent variables. Finally, we will collect and analyze primary qualitative data from TNB persons to further understand their barriers and facilitators to non-HIV STI testing. This study will inform future research focused on developing, evaluating, and implementing interventions which increase non-HIV STI testing among TNB populations, filling critical gaps in research specifically to the needs of overlooked groups of trans men and nonbinary people.

项目摘要 研究表明，跨性别人群是一个多元化的群体，其 性别认同和/或表达不同于与其性别相关的社会期望 出生时就被标记为非艾滋病毒性传播感染 (STI) 的比率很高。未经处理的非 艾滋病毒性传播感染可能导致负面健康结果和社区传播。所以， 获得非艾滋病毒性传播感染检测对于降低发病率和促进公众健康至关重要 健康。在已发表的针对跨性别者非艾滋病毒性传播感染检测的研究中， 人口焦点有限（几乎全是跨性别女性）。值得注意的是，不存在非二元的 人（不完全认为是男性或女性的人），尽管该群体包括 美国 1/3 的跨性别者 很少有文献研究非跨性别者中基于性别的差异 跨性别者和非二元性别 (TNB) 人群中的 HIV STI 检测。此外，信息差距还 关于 TNB 人群中非 HIV STI 检测的障碍和促进因素，以及如何 这些障碍和促进因素可能因性别而异。为了解决这些差距，我们的团队将检查 性活跃的 TNB 人群是否具有基于性别的差异（反式 女性/跨性别男性/非二元性别人士）的非艾滋病毒性传播感染检测率和障碍以及 非艾滋病毒性传播感染检测的促进者。我们将进行解释性顺序混合方法 使用 2018 年密歇根跨性别健康调查 (MTHS) 的二级定量数据进行的研究 以及利用在线焦点小组对 TNB 人员进行的初步定性研究。首先，我们将确定 基于性别的差异：a) 终生非 HIV STI 检测史（从未、曾经）和 b) 的比率 性活跃人群中自上次非 HIV STI 检测以来的时间（从未、过去一年、1-5 年、>5 年） 国能人士。然后，根据社会生态学的综合概念框架， 少数群体压力和性别肯定，我们将检查个人（例如种族/民族）是否 医疗（例如激素治疗）；社会（例如，基于性别认同的服务提供者歧视）； 和结构性（例如，临床性别肯定）因素与终生非性别独特相关。 HIV STI 检测历史以及性别认同是否会调节一生之间的关联 非 HIV STI 检测历史和统计上显着相关的自变量。最后， 我们将收集和分析TNB人员的主要定性数据，以进一步了解他们的 非 HIV 性传播感染检测的障碍和促进因素。这项研究将为未来的研究提供信息 制定、评估和实施增加非艾滋病毒性传播感染检测的干预措施 TNB 人群中，填补研究方面的关键空白，专门满足被忽视的人群的需求 跨性别者和非二元性别人群。

项目成果

HIV testing among transgender and nonbinary persons in Michigan, United States: results of a community-based survey.

• DOI: 10.1002/jia2.25972
• 发表时间: 2022-10
• 期刊: Journal of the International AIDS Society
• 影响因子: 6

Sexually transmitted infection testing among transgender and non-binary persons: results of a community-based cross-sectional survey.

跨性别者和非二元性别者的性传播感染检测：基于社区的横断面调查结果。

• DOI: 10.1071/sh22128
• 发表时间: 2023
• 期刊: Sexual health
• 影响因子: 1.6
• 作者: Lacombe-Duncan,Ashley;Kattari,ShannaK;Kattari,Leonardo;Scheim,AydenI;Misiolek,BraydenA
• 通讯作者: Misiolek,BraydenA