scholarly journals Integration of Gender-Affirming Primary Care and Peer Navigation With HIV Prevention and Treatment Services to Improve the Health of Transgender Women: Protocol for a Prospective Longitudinal Cohort Study

10.2196/14091 ◽  
2019 ◽  
Vol 8 (6) ◽  
pp. e14091 ◽  
Author(s):  
Javier R Lama ◽  
Kenneth H Mayer ◽  
Amaya G Perez-Brumer ◽  
Leyla Huerta ◽  
Hugo Sanchez ◽  
...  
2019 ◽  
Author(s):  
Javier R Lama ◽  
Kenneth H Mayer ◽  
Amaya G Perez-Brumer ◽  
Leyla Huerta ◽  
Hugo Sanchez ◽  
...  

BACKGROUND Public health strategies are urgently needed to improve HIV disparities among transgender women, including holistic intervention approaches that address those health needs prioritized by the community. Hormone therapy is the primary method by which many transgender women medically achieve gender affirmation. Peer navigation has been shown to be effective to engage and retain underserved populations living with HIV in stable primary medical care. OBJECTIVE This study aims to assess the feasibility and acceptability of an integrated innovative HIV service delivery model designed to improve HIV prevention and care by combining gender-affirming primary care and peer navigation with HIV prevention and treatment services. METHODS A 12-month, nonrandomized, single-arm cohort study was implemented in Lima, Peru, among adult individuals, assigned a male sex at birth, who identified themselves as transgender women, regardless of initiation or completion of medical gender affirmation, and who were unaware of their HIV serostatus or were living with HIV but not engaged in HIV treatment. HIV-negative participants received quarterly HIV testing and were offered to initiate pre-exposure prophylaxis. HIV-positive participants were offered to initiate antiretroviral treatment and underwent quarterly plasma HIV-1 RNA and peripheral CD4+ lymphocyte cell count monitoring. All participants received feminizing hormone therapy and adherence counseling and education on their use. Peer health navigation facilitated retention in care by visiting participants at home, work, or socialization venues, or by contacting them by social media and phone. RESULTS Patient recruitment started in October 2016 and finished in March 2017. The cohort ended follow-up on March 2018. Data analysis is currently underway. CONCLUSIONS Innovative and culturally sensitive strategies to improve access to HIV prevention and treatment services for transgender women are vital to curb the burden of HIV epidemic for this key population. Findings of this intervention will inform future policies and research, including evaluation of its efficacy in a randomized controlled trial. CLINICALTRIAL ClinicalTrials.gov NCT03757117; https://clinicaltrials.gov/ct2/show/NCT03757117 INTERNATIONAL REGISTERED REPOR DERR1-10.2196/14091


2013 ◽  
Vol 63 (612) ◽  
pp. e499-e505 ◽  
Author(s):  
Jamie Parmenter ◽  
Caroline Mitchell ◽  
Jenny Keen ◽  
Phillip Oliver ◽  
Georgina Rowse ◽  
...  

Kinesiology ◽  
2021 ◽  
Vol 53 (2) ◽  
pp. 336-342
Author(s):  
Pedro Ángel Latorre Román ◽  
Juan Antonio Párraga Montilla ◽  
Jeśús Salas Sánchez ◽  
Pedro José Consuegra González

Rearfoot strike (RFS) in children running produces impact forces that give rise to a transient stress wave traveling through the body. It could contribute to the development of injuries. The purpose of this study was to determine RFS prevalence during childhood while running at a self-selected velocity in a prospective longitudinal cohort study. A total of 175 children (68 girls), aged 6 to 14 years, participated in this study. The sample was divided into three age groups (age in 2016): 6-8 years, 9-11 years, and 12-14 years which were analysed three years later (2019). 2D video-based was used to record the RFS Taking into account all samples, in the jogging trial the prevalence of RFS (an average of both feet) was 86.9% in 2016 and 94.7% three years later; in the running trial the prevalence was 82.6 and 94.4%, respectively. In all samples a significant increase of RFS prevalence was found in both the jogging and running trials for both feet over three years (jogging, left foot, p=.011, right foot, p=.023; running, left foot, p=.001, right foot, p<.001). In girls, there were no significant differences in any conditions. In boys, a significant increase of RFS prevalence was found after three years in both feet (p<.01) in the running trial. This study shows that RFS prevalence in children increases with age and the results may be used to characterize typical running development in children population.


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