Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot

BMC Medical Education

卷:21

Gabrielle Leblanc¹  Chavisa Horemans²  Tara Lyons³  Ayden I. Scheim⁴  Kelendria Nation⁵  Hannah Kia⁶  Ronke Olawale⁷  Ashley Lacombe-Duncan⁷  Yasmeen Persad⁸  Carmen H. Logie⁸  Mona Loutfy⁸ 

[1] Action Santé Travesti(e)s & Transsexuel(le)s du Québec (ASTT(E)Q);

[2] CIHR Canadian HIV Trials Network;

[3] Center for Gender & Sexual Health Equity (CGSHE);

[4] Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Drexel University;

[5] Prism Education Series, Vancouver Coastal Health;

[6] School of Social Work, University of British Columbia;

[7] School of Social Work, University of Michigan;

[8] Women’s College Research Institute, Women’s College Hospital;

关键词: Transgender;    Stigma;    Health care;    Provider;    Social services;    HIV prevention;   

DOI  :  10.1186/s12909-021-02991-3

来源: DOAJ

【 摘 要 】

Abstract Background Transgender (trans) women face constrained access to gender-affirming HIV prevention and care. This is fueled in part by the convergence of limited trans knowledge and competency with anti-trans and HIV-related stigmas among social and healthcare providers. To advance gender-affirming HIV service delivery we implemented and evaluated ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’. This theoretically-informed community-developed intervention aimed to increase providers’ gender-affirming HIV prevention and care knowledge and competency and reduce negative attitudes and biases among providers towards trans women living with and/or affected by HIV. Methods Healthcare and social service providers and providers in-training (e.g., physicians, nurses, social workers) working with trans women living with and/or affected by HIV (n = 78) participated in a non-randomized multi-site pilot study evaluating TEACHH with a pre-post-test design. Pre- and post-intervention surveys assessed participant characteristics, intervention feasibility (e.g., workshop completion rate) and acceptability (e.g., willingness to attend another training). Paired sample t-tests were conducted to assess pre-post intervention differences in perceived competency, attitudes/biases, and knowledge to provide gender-affirming HIV care to trans women living with HIV and trans persons. Results The intervention was feasible (100% workshop completion) and acceptable (91.9% indicated interest in future gender-affirming HIV care trainings). Post-intervention scores indicated significant improvement in: 1) knowledge, attitudes/biases and perceived competency in gender-affirming HIV care (score mean difference (MD) 8.49 (95% CI of MD: 6.12–10.86, p < 0.001, possible score range: 16–96), and 2) knowledge, attitudes/biases and perceived competency in gender-affirming healthcare (MD = 3.21; 95% CI of MD: 1.90–4.90, p < 0.001, possible score range: 9–63). Greater change in outcome measures from pre- to post-intervention was experienced by those with fewer trans and transfeminine clients served in the past year, in indirect service roles, and having received less prior training. Conclusions This brief healthcare and social service provider intervention showed promise in improving gender-affirming provider knowledge, perceived competency, and attitudes/biases, particularly among those with less trans and HIV experience. Scale-up of TEACHH may increase access to gender-affirming health services and HIV prevention and care, increase healthcare access, and reduce HIV disparities among trans women. Trial registration ClinicalTrials.gov ( NCT04096053 ).

【 授权许可】

Unknown