目标:跨性别者存在与饮酒相关的健康不平等。虽然泰国公共卫生部最近发布了一项实施筛查的临床指南,初级保健中的短暂干预和转诊治疗(SBIRT),没有关于跨性别女性(TGW)饮酒和在泰国背景下实施SBIRT的可接受性的研究,这项研究旨在填补这一空白。
方法:采用混合方法。在第一阶段,TGW服务用户和医疗保健提供者(HCP)完成了一项关于预期实施SBIRT的可接受性的调查。TGW服务用户完成了酒精使用障碍识别测试-消费(AUDIT-C)。在第二阶段,TGW服务用户,HCP,诊所管理员和国家一级的酒精,艾滋病毒和跨性别卫生政策制定者参加了深入的定性访谈。
方法:橘子诊所,曼谷一家由变性人主导的性健康诊所,泰国。
方法:在第一阶段,对TGW服务用户(n=100)和HCP(n=8)进行了调查。在第二阶段,采访了22个利益相关者(n=10个TGW服务用户;n=8个HCP;n=1个诊所管理员;n=3个决策者)。
方法:计算每个调查项目的简单比例。使用单变量分析计算了各种人口统计学因素的可接受性差异。定性数据使用主题分析和演绎方法进行编码。结果被映射到实施研究领域和结构的合并框架。对定量和定性结果进行了三角剖分,以扩大理解。
结果:50%的TGW参与者表现出问题的饮酒水平(AUDIT-C≥4)。实施SBIRT是高度可接受的,超过95%的参与者报告同意或完全同意接受酒精使用SBIRT。屏障,比如复杂性,时间紧迫,缺乏知识和技能,是预期的。适应性,例如调整简短干预的内容以适应TGW的健康需求,并调整SBIRT以适应现有的临床程序,可能有助于成功实施。
结论:筛查,酒精使用的短暂干预和转诊治疗(SBIRT)有可能在变性人主导的性健康诊所环境中成功实施。通过一些适应来克服预期的障碍。
Health inequities related to alcohol use exist for transgender individuals. While the Thailand Ministry of Public Health recently published a clinical guideline to implement a Screening, Brief Intervention and Referral to Treatment (
SBIRT) in primary care, there has been no study regarding transgender women\'s (TGW) alcohol use and the acceptability of implementing
SBIRT in a Thai context, a gap this study aimed to fill.
A mixed-method approach was used. In the first phase, TGW service users and health-care providers (HCPs) completed a survey on the acceptability of prospective implementation of SBIRT. TGW service users completed the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). In the second phase, TGW service users, HCPs, clinic administrators and national-level alcohol, HIV and transgender health policymakers participated in in-depth qualitative interviews.
The Tangerine Clinic, a transgender-led sexual health clinic in Bangkok, Thailand.
In the first phase, TGW service users (n = 100) and HCP (n = 8) were surveyed. In the second phase, 22 stakeholders (n = 10 TGW service users; n = 8 HCP; n = 1 clinic administrator; n = 3 policymakers) were interviewed.
Simple proportions were calculated for each survey item. Differences in acceptability by various demographic factors were calculated using univariate analysis. The qualitative data were coded using thematic analysis and a deductive approach. The results were mapped to the Consolidated Framework for Implementation Research domains and constructs. The quantitative and qualitative results were triangulated to expand understanding.
Fifty per cent of the TGW participants exhibited problematic drinking levels (AUDIT-C ≥ 4). Implementing SBIRT was highly acceptable, as more than 95% of participants reported agreeing or completely agreeing to receive
SBIRT for alcohol use. Barriers, such as complexity, time constraint and lack of knowledge and skills, were anticipated. Adaptability, such as tailoring the content of brief intervention to suit TGW health needs and
SBIRT to fit with existing clinic procedures, might facilitate successful implementation.
Screening, Brief Intervention and Referral to Treatment (
SBIRT) for alcohol use has the potential to be successfully implemented in transgender-led sexual health clinic settings, with some adaptations to overcome anticipated barriers.