Behaviors associated with HIV transmission risk among rural sexual and gender minority and majority residents

Jenkins, Wiley D.; Phillips, Gregory; Rodriguez, Christofer; White, Megan; Agosto, Stacy; Luckey, Georgia

doi:10.1080/09540121.2023.2179592

Cited by 4 publications

(2 citation statements)

References 48 publications

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“…Shorter travel time to one's PrEP provider was the third most important attribute among respondents regardless of PrEP status. Lack of geographically accessible medical services is an important barrier to attending medical visits, including visits for PrEP-related care, among people who reside in rural areas or impoverished neighbourhoods [22,103,[112][113][114]. Prior studies also found that even in large metropolitan areas, trans patients often reported that ride-share services were cost-prohibitive and travelling by public transportation was time-consuming or exposed them to discrimination or violence [27,115,116].…”

Section: Table 2 Results Of Choice-based Conjoint Analysis Experiment...mentioning

confidence: 99%

HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

Watson,

Listerud,

Drab

et al. 2024

J Int AIDS Soc.

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IntroductionCurrent implementation efforts have failed to achieve equitable HIV pre‐exposure prophylaxis (PrEP) provision for transgender and gender‐diverse (trans) populations. We conducted a choice‐based conjoint analysis to measure preferences for key attributes of hypothetical PrEP delivery programmes among a diverse online sample predominantly comprised of transmasculine and nonbinary individuals in the United States.MethodsBetween April 2022 and June 2022, a national online survey with an embedded conjoint analysis experiment was conducted among 304 trans individuals aged ≥18 years in the United States to assess five PrEP programme attributes: out‐of‐pocket cost; dispensing venue; frequency of visits for PrEP‐related care; travel time to PrEP provider; and ability to bundle PrEP‐related care with gender‐affirming hormone therapy services. Participants responded to five questions, each of which presented two PrEP programme scenarios and one opt‐out option per question and selected their preferred programme in each question. We used hierarchical Bayes estimation and multinomial logistic regression to measure part‐worth utility scores for the total sample and by respondents’ PrEP status.ResultsThe median age was 24 years (range 18–56); 75% were assigned female sex at birth; 54% identified as transmasculine; 32% as nonbinary; 14% as transfeminine. Out‐of‐pocket cost had the highest attribute importance score (44.3%), followed by the ability to bundle with gender‐affirming hormone therapy services (18.7%). Minimal cost‐sharing ($0 out‐of‐pocket cost) most positively influenced the attribute importance of cost (average conjoint part‐worth utility coefficient of 2.5 [95% CI 2.4−2.6]). PrEP‐experienced respondents preferred PrEP delivery in primary care settings (relative utility score 4.7); however, PrEP‐naïve respondents preferred pharmacies (relative utility score 5.1).ConclusionsParticipants preferred programmes that offered PrEP services without cost‐sharing and bundled with gender‐affirming hormone therapy services. Bolstering federal regulations to cover PrEP services and prioritizing programmes to expand low‐barrier PrEP provision are critical to achieving equitable PrEP provision. Community‐engaged implementation research conducted by and in close collaboration with trans community stakeholders and researchers are needed to streamline the design of patient‐centred PrEP programmes and develop implementation strategies that are salient to the diverse sexual health needs of trans patients.

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Section: Table 2 Results Of Choice-based Conjoint Analysis Experiment...mentioning

confidence: 99%

HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

Watson,

Listerud,

Drab

et al. 2024

J Int AIDS Soc.

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“…Furthermore, sexual and gender minorities, who are disproportionately affected by HIV (Jenkins et al, 2023 ; Clair et al, 2024 ; Scanlon et al, 2024 ), face distinct challenges, including societal stigma, gender-based violence and discrimination, and lack of culturally competent care, exacerbating barriers to HIV care and widening the health disparity gap among these marginalized communities (Wilson et al, 2013 ; Nelson et al, 2014 ). Addressing these multifaceted barriers is essential to ensuring equitable access to HIV care and improving outcomes in the HIV care continuum.…”

Section: Introductionmentioning

confidence: 99%

Medical-Legal Partnerships: a promising approach for addressing health-harming legal needs among people with HIV

Jaén,

Frankel,

French

et al. 2024

Front. Sociol.

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IntroductionPeople with HIV (PWH), particularly those at the intersection of sexual and gender identities, face enduring obstacles to accessing HIV care, including structural stigma, structural racism and discrimination, housing instability, and limited access to health insurance. To address these challenges, Medical-Legal Partnerships (MLPs) in HIV care offer an innovative approach that integrates medical and legal services. By targeting health-harming legal needs (HHLN), MLPs aim to enhance the HIV care continuum outcomes for PWH.MethodsThis study examines the benefits and challenges of MLPs within organizations serving PWH through the social-ecological model. MLP providers (n=111) identified organizational-level challenges such as funding limitations, resource integration issues, and staffing constraints.ResultsMLPs demonstrated numerous benefits, including patient impact and benefits, comprehensive service provision, enhanced staff support and capacity, and potential for policy influence.DiscussionThese results underscore the feasibility of MLPs while offering valuable insights into their efficacy and challenges, guiding the implementation of MLPs to address health-harming legal needs, including discrimination, and thereby improving HIV care outcomes.

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Opioid and polydrug use among rural sexual and gender minorities: Current knowledge and future directions

Ezell

2023

International Journal of Drug Policy

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Behaviors associated with HIV transmission risk among rural sexual and gender minority and majority residents

Cited by 4 publications

References 48 publications

HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

Medical-Legal Partnerships: a promising approach for addressing health-harming legal needs among people with HIV

Opioid and polydrug use among rural sexual and gender minorities: Current knowledge and future directions

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