Gender affirmative HIV care framework: Decisions on feminizing hormone therapy (FHT) and antiretroviral therapy (ART) among transgender women
Year: 2019
Type: article
Abstract: BACKGROUND: Integration of feminizing hormone therapy (FHT) and antiretroviral therapy (ART) is critical in providing gender-affirming HIV care for transgender (trans) women living with HIV. However, interpersonal communications with HIV providers who are not competent with FHT may complicate this integration. METHODS: We conducted semi-structured interviews with trans women (n = 9) who self-reported as HIV-positive and their HIV providers (n = 15) from community-based venues (e.g., clinics) in Manila, Philippines. RESULTS: We identified five key themes from our qualitative data: (1) provider's concerns; (2) patient's goals; (3) affirmative vs. non-affirmative provider rhetoric; (4) alignment vs. misalignment of provider rhetoric to patient goals; and (5) FHT and ART-related decisions. Based on these themes, we describe a gender-affirmative HIV care framework to understand FHT-ART decisions among trans women living with HIV. Based on our data, this framework shows that provider-patient communications regarding ART and FHT consists primarily of provider concerns and patient goals regarding FHT. These communications can take on a gender-affirmative or non-affirmative style of rhetoric that either aligns or misaligns with patient goals and may lead to differences in FHT and ART-related decisions among trans women living with HIV. CONCLUSION: There exist mixed regimens and beliefs about taking FHT and ART among this sample of trans women. While trans participants' main source of health information is their HIV provider, providers are likely to communicate non-affirmative rhetoric that negatively impacts trans women's decision to take FHT and ART. Research is needed to elucidate co-prescriptions of gender-affirmative services with HIV care among this group in the Philippines.
Source: PLoS ONE
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,595
Funders: Robert Wood Johnson Foundation, amfAR, The Foundation for AIDS Research, Brown University, National Institutes of Health, Center for AIDS Research, University of Washington, National Institute of Mental Health, National Institute on Drug Abuse, National Institute of General Medical Sciences, National Institute of Allergy and Infectious Diseases, Fogarty International Center, National Institute on Minority Health and Health Disparities, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1276500078, Brown NIMHD Minority Health & Health Disparities International Research Training, G1363540049, G269439005, G326420316, Brown University and University of the Philippines Training Program for the Prevention of HIV in Vulnerable Populations, G4137278198, Characterizing the Philippines HIV Epidemic: A Community-Informed Approach to Examine Substance use, HIV RIsk, and HIV Prevention Services Uptake among Transgender Women and Men Who Have Sex with Men, Advancing the Culture of Ph.D. Learning and Scholarship in Biology and Health Science, Minority Populations Prevention Researcher Training, G7160317190, G8977204660, Providence/Boston Center for AIDS Research (CFAR), Training for Scientists Conducting Research to Reduce HIV/AIDS Health Disparities, HIV and Other Infectious Consequences of Substance Use, Brown University Community and Clinical Research Training Program, HIV Center for Clinical and Behavioral Studies
OpenAlex ID: W2981774614