Đại dịch toàn cầu về nhiễm virus HIV và các điều kiện đồng hiện liên quan đến sự ảnh hưởng của người chuyển giới
Tóm tắt
Các quần thể người chuyển giới đã bị thiếu vắng trong các nghiên cứu dịch tễ học về HIV và do đó cũng thiếu thốn trong các chương trình phòng ngừa, chăm sóc và điều trị HIV. Từ năm 2012, đã có sự gia tăng đáng kể trong nghiên cứu tập trung vào người chuyển giới. Các nghiên cứu làm nổi bật gánh nặng của bệnh HIV và những yếu tố nguy cơ, bao gồm các định kiến giao thoa, như là động lực của các tình trạng đồng hiện trong các quần thể người chuyển giới. Bài tổng quan này tổng hợp dịch tễ học HIV toàn cầu gần đây và mô tả những khoảng trống hiện tại trong nghiên cứu và can thiệp để thông tin hóa việc ưu tiên nghiên cứu HIV cho các quần thể người chuyển giới.
Một cuộc tổng quan có hệ thống đã được thực hiện đối với tài liệu y khoa được công bố giữa ngày 1 tháng 1 năm 2012 và ngày 30 tháng 11 năm 2015. Dữ liệu tập trung vào tỷ lệ nhiễm HIV, các yếu tố nguy cơ và các tình trạng đồng hiện trong các quần thể người chuyển giới.
Các ước tính thay đổi đáng kể theo vị trí địa lý và tiểu quần thể. Những cá nhân chuyển nữ có tỷ lệ nhiễm HIV tập trung cao nhất trên thế giới với tỷ lệ xác nhận trong phòng thí nghiệm lên tới 40%. Dữ liệu khá hiếm về các cá nhân chuyển nam; tuy nhiên, chúng cho thấy khả năng có nguy cơ cao hơn cho nam chuyển giới có quan hệ tình dục với nam (MSM). Không có dữ liệu về tỷ lệ nhiễm bệnh cho người chuyển giới ở khu vực châu Phi hạ Sahara hoặc đông Âu/trung Á. Các dữ liệu mới nổi liên tục hỗ trợ mối liên hệ của các điều kiện đồng hiện với nguy cơ HIV trong các quần thể người chuyển giới.
Giải quyết các điều kiện đồng hiện và những thách thức đặc thù về giới tính là rất quan trọng để đảm bảo sự tham gia và duy trì trong phòng ngừa HIV bởi các quần thể người chuyển giới. Nghiên cứu trong tương lai nên ưu tiên: lấp đầy các khoảng trống kiến thức trong dịch tễ học HIV; làm rõ cách thức mà định kiến hình thành các yếu tố đồng hiện để tạo ra HIV và những tác động tiêu cực khác đến sức khỏe của người chuyển giới; và hiểu cách thức để thực hiện hiệu quả các can thiệp HIV cho người chuyển giới.
Từ khóa
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