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“I do the she and her”: A qualitative exploration of HIV care providers’ considerations of trans women in gender-specific HIV care

OBJECTIVES: Women of all genders, including cisgender (cis) and transgender (trans) women, experience social and structural drivers of HIV inequities and pervasive barriers to HIV care. Yet, little is known about how HIV care providers address gender diversity in health care. Through a critical femi...

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Autores principales: Lacombe-Duncan, Ashley, Berringer, Kathryn R, Green, Jennifer, Jacobs, Amy, Hamdi, Amy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935587/
https://www.ncbi.nlm.nih.gov/pubmed/35311400
http://dx.doi.org/10.1177/17455057221083809
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author Lacombe-Duncan, Ashley
Berringer, Kathryn R
Green, Jennifer
Jacobs, Amy
Hamdi, Amy
author_facet Lacombe-Duncan, Ashley
Berringer, Kathryn R
Green, Jennifer
Jacobs, Amy
Hamdi, Amy
author_sort Lacombe-Duncan, Ashley
collection PubMed
description OBJECTIVES: Women of all genders, including cisgender (cis) and transgender (trans) women, experience social and structural drivers of HIV inequities and pervasive barriers to HIV care. Yet, little is known about how HIV care providers address gender diversity in health care. Through a critical feminist lens informed by intersectionality theory, medical anthropology, and critical sociology, we explored (1) how do HIV care providers describe women living with HIV’s care needs and barriers; (2) what are their perspectives on optimal HIV care for women; and (3) to what extent do these conceptualizations include/exclude trans women. METHODS: Utilizing a community-based exploratory qualitative study design, we conducted 60–90 minute semi-structured individual interviews from March 2019–April 2020 with eight HIV care providers (n = 4 social service providers; n = 4 physicians) practicing across seven counties representative of rural, suburban, and urban Michigan, United States. Data were analyzed utilizing a reflexive thematic approach. RESULTS: Three overarching themes emerged: (1) Emphasis on (different) clinical needs: key considerations in cis and trans women’s HIV care; (2) Recognition of the structural: barriers to HIV care affecting women of all genders; and (3) Proposed solutions: piecing together individual, social, and organizational interventions to increase access to HIV care that may benefit women living with HIV of all genders but are disproportionately framed as being for cis women. While HIV care providers recognized both cis and trans women living with HIV’s clinical care needs and structural barriers to care, they rarely envisioned optimal HIV care inclusive of gender affirmation and structural interventions. CONCLUSIONS: Findings suggest that HIV care providers can avoid reducing gender to biology and making assumptions about reproductive care needs, endocrinological care needs, caregiving responsibilities, and other life circumstances; provide gender-affirming medical care; and address structural barriers to HIV care to enhance intersectional and structurally focused gender-affirming—that is, trans-inclusive—women-centered HIV care.
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spelling pubmed-89355872022-03-22 “I do the she and her”: A qualitative exploration of HIV care providers’ considerations of trans women in gender-specific HIV care Lacombe-Duncan, Ashley Berringer, Kathryn R Green, Jennifer Jacobs, Amy Hamdi, Amy Womens Health (Lond) HIV and Women’s Health: Where Are We Now? OBJECTIVES: Women of all genders, including cisgender (cis) and transgender (trans) women, experience social and structural drivers of HIV inequities and pervasive barriers to HIV care. Yet, little is known about how HIV care providers address gender diversity in health care. Through a critical feminist lens informed by intersectionality theory, medical anthropology, and critical sociology, we explored (1) how do HIV care providers describe women living with HIV’s care needs and barriers; (2) what are their perspectives on optimal HIV care for women; and (3) to what extent do these conceptualizations include/exclude trans women. METHODS: Utilizing a community-based exploratory qualitative study design, we conducted 60–90 minute semi-structured individual interviews from March 2019–April 2020 with eight HIV care providers (n = 4 social service providers; n = 4 physicians) practicing across seven counties representative of rural, suburban, and urban Michigan, United States. Data were analyzed utilizing a reflexive thematic approach. RESULTS: Three overarching themes emerged: (1) Emphasis on (different) clinical needs: key considerations in cis and trans women’s HIV care; (2) Recognition of the structural: barriers to HIV care affecting women of all genders; and (3) Proposed solutions: piecing together individual, social, and organizational interventions to increase access to HIV care that may benefit women living with HIV of all genders but are disproportionately framed as being for cis women. While HIV care providers recognized both cis and trans women living with HIV’s clinical care needs and structural barriers to care, they rarely envisioned optimal HIV care inclusive of gender affirmation and structural interventions. CONCLUSIONS: Findings suggest that HIV care providers can avoid reducing gender to biology and making assumptions about reproductive care needs, endocrinological care needs, caregiving responsibilities, and other life circumstances; provide gender-affirming medical care; and address structural barriers to HIV care to enhance intersectional and structurally focused gender-affirming—that is, trans-inclusive—women-centered HIV care. SAGE Publications 2022-03-19 /pmc/articles/PMC8935587/ /pubmed/35311400 http://dx.doi.org/10.1177/17455057221083809 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle HIV and Women’s Health: Where Are We Now?
Lacombe-Duncan, Ashley
Berringer, Kathryn R
Green, Jennifer
Jacobs, Amy
Hamdi, Amy
“I do the she and her”: A qualitative exploration of HIV care providers’ considerations of trans women in gender-specific HIV care
title “I do the she and her”: A qualitative exploration of HIV care providers’ considerations of trans women in gender-specific HIV care
title_full “I do the she and her”: A qualitative exploration of HIV care providers’ considerations of trans women in gender-specific HIV care
title_fullStr “I do the she and her”: A qualitative exploration of HIV care providers’ considerations of trans women in gender-specific HIV care
title_full_unstemmed “I do the she and her”: A qualitative exploration of HIV care providers’ considerations of trans women in gender-specific HIV care
title_short “I do the she and her”: A qualitative exploration of HIV care providers’ considerations of trans women in gender-specific HIV care
title_sort “i do the she and her”: a qualitative exploration of hiv care providers’ considerations of trans women in gender-specific hiv care
topic HIV and Women’s Health: Where Are We Now?
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935587/
https://www.ncbi.nlm.nih.gov/pubmed/35311400
http://dx.doi.org/10.1177/17455057221083809
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