Evaluating for health equity among a cluster of health departments implementing PrEP services

被引:8
作者
Carter, Jarvis W., Jr. [1 ]
Salabarria-Pena, Yamir [1 ]
Fields, Errol L. [2 ]
Robinson, William T. [3 ,4 ]
机构
[1] Ctr Dis Control & Prevent, Natl Ctr HIV AIDS Viral Hepatitis STD & TB Preven, Div HIV Prevent, 1600 Clifton Rd NE, Atlanta, GA 30329 USA
[2] Johns Hopkins Sch Med, Dept Pediat, Div Adolescent Young Adult Med, 200 N Wolfe St, Baltimore, MD 21287 USA
[3] Off Publ Hlth, Louisiana Dept Hlth, 1450 Poydras St, New Orleans, LA 70112 USA
[4] Louisiana State Univ, Hlth Sci Ctr, Sch Publ Hlth, 2020 Gravier St, New Orleans, LA 70112 USA
关键词
HIV; PrEP; Cluster evaluation; Health equity; Social determinants; Racial; ethnic minorities; Sexual minorities; Gender minorities; Transgender; AFRICAN-AMERICAN MEN; HIV-RELATED STIGMA; WHITE MEN; MEDICAL MISTRUST; UNITED-STATES; TRANSGENDER WOMEN; CARE PROVIDERS; BLACK-MEN; SEX; DISPARITIES;
D O I
10.1016/j.evalprogplan.2021.101981
中图分类号
C [社会科学总论];
学科分类号
03 ; 0303 ;
摘要
African American/Black and Hispanic/Latino sexual and gender minority populations are disproportionately affected by HIV in the United States and continue to experience HIV-related disparities. CDC funded project PrIDE to support 12 health departments (HD) with implementing pre-exposure prophylaxis (PrEP) strategies for men who have sex with men (MSM) and transgender persons, with a health-equity focus established by HDs. Each HD conducted mixed-methods evaluation of at least one local strategy. CDC employed a cluster evaluation approach to maximize cross validation. As a result, this cluster evaluation focused on three HDs that evaluated health equity-focused PrEP implementation strategies. Findings suggest that integrating health equity strategies such as storytelling and healthcare worker (HCW) trainings can help reduce HIV-related disparities. Storytelling improved HCW's understanding of clients' experiences of stigma due to racial, gender, and sexual identities. Provider training increased competencies on culturally appropriate care and the use of clinic services by Black and Hispanic MSM and transgender persons. Good practices included community engagement, seeking leadership buy-in, and integration of programmatic staff in health equity and evaluation activities. Evaluating strategies and training policies addressing social determinants of health that adversely affect HIV outcomes may help mitigate barriers Black and Hispanic MSM and transgender populations encounter in their HIV prevention seeking efforts.
引用
收藏
页数:6
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