Gender-Based Violence and Post-traumatic Stress Disorder Symptoms Predict HIV PrEP Uptake and Persistence Failure Among Transgender and Non-binary Persons Participating in a PrEP Demonstration Project in Southern California
| Autor: | Erik D. Storholm, Wenjing Huang, Adedotun Ogunbajo, Keith J. Horvath, Cathy J. Reback, Jill Blumenthal, David J. Moore, Risa P. Flynn, Robert K. Bolan, Katya C. Corado, Sheldon R. Morris |
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| Rok vydání: | 2023 |
| Předmět: |
Male
Social Work Social Psychology Anti-HIV Agents HIV prevention HIV Infections Gender-Based Violence Sexual and Gender Minorities (SGM/LGBT*) Transgender Persons Article California Behavioral and Social Science Humans Medication adherence Health equity Stress Disorders PrEP persistence Peace Prevention Public Health Environmental and Occupational Health Homosexuality Gender Equality Post-Traumatic Stress Disorder (PTSD) Anxiety Disorders Justice and Strong Institutions Brain Disorders Infectious Diseases Mental Health Good Health and Well Being Post-Traumatic Transgender Public Health and Health Services Pre-Exposure Prophylaxis Public Health |
| Zdroj: | AIDS and behavior, vol 27, iss 2 AIDS Behav |
| Popis: | Gender-based violence (GBV) against transgender and nonbinary (TGNB) persons is a pervasive public health issue. GBV has been linked to mental health problems such as depression and posttraumatic stress disorder (PTSD), as well has risk for HIV seroconversion and HIV treatment nonadherence. However, the impact of GBV on HIV pre-exposure prophylaxis (PrEP) use among TGNB persons has yet to be investigated. In the current study we assessed longitudinal PrEP persistence data from dried blood spots (DBS) collected from 172 racially and ethnically diverse TGNB participants during a 48-week PrEP demonstration project in Southern California from June 2017 to September 2020. Participants were categorized into three levels of PrEP uptake and persistence based on their PrEP levels at the start and end of the study: low-low, high-low, and high-high. Individual-, social-, and structural-level variables were then entered into multinomial logistic regression models to predict levels of PrEP uptake and persistence based on hypotheses informed by syndemic and minority stress theories. The models demonstrated that experience of GBV predicted significantly lower odds of PrEP uptake and persistence and greater PTSD symptoms predicted significantly greater odds of early PrEP discontinuation. Higher levels of coping skills, already being on PrEP at baseline, and being in a steady relationship were associated with greater odds of PrEP uptake and persistence. Implications forfuture GBV research, advocacy, interventions, and much needed structural changes focused on improving the health and safety of TGNB individuals are discussed. |
| Databáze: | OpenAIRE |
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