Risultati per: Transgender – Competenze e ruoli del medico di medicina generale

Francesca Pasinelli lascia i ruoli operativi, ma resta nel Consiglio

Francesca Pasinelli lascia i ruoli operativi, ma resta nel Consiglio

Introduction
Persistent infection with high-risk human papillomavirus (HPV) is the causal agent of several cancers including cervical, anal and oropharyngeal cancer. Transgender men and transmasculine non-binary (TMNB) people with a cervix are much less likely to undergo cervical cancer screening than cisgender women. Transgender women and transfeminine non-binary (TWNB) people assigned male at birth may be at increased risk of HPV. Both TMNB and TWNB people face many barriers to HPV testing including medical mistrust due to stigma and discrimination.

Methods and analysis
The Self-TI Study (Self-TI) is a pilot study designed to measure acceptability and feasibility of HPV self-testing among transgender and non-binary people in England. TMNB people aged 25–65 years, with at least 1 year of testosterone, and TWNB people, aged 18 years and over, are eligible to participate. Participants self-collect up to four samples: an oral rinse, a first void urine sample, a vaginal swab (if applicable) and an anal swab. TMNB participants are asked to have an additional clinician-collected cervical swab taken following their routine Cervical Screening Programme sample. TWNB people are asked to take a self-collection kit to perform additional self-collection at home and mail the samples back to the clinic. Acceptability is assessed by a self-administered online survey and feasibility is measured as the proportion of samples returned in the clinic and from home.

Ethics and dissemination
Self-TI received ethical approval from the Research Ethics Committee of Wales 4 and ethical review panel within the Division of Cancer Epidemiology and Genetics at the US National Cancer Institute. Self-TI was coproduced by members of the transgender and non-binary community, who served as authors, collaborators and members of the patient and public involvement (PPI) group. Results of this study will be shared with the community prior to being published in peer-reviewed journals and the PPI group will help to design the results dissemination strategy. The evidence generated from this pilot study could be used to inform a larger, international study of HPV self-testing in the transgender and non-binary community.

Trial registration number
NCT05883111.

This case series study examines clinical outcomes of isotretinoin among transgender and gender-diverse individuals receiving gender-affirming hormonal therapy.

Annals of Internal Medicine, Ahead of Print.

Introduction
Globally, transgender (‘trans’) women experience extreme social and economic marginalisation due to intersectional stigma, defined as the confluence of stigma that results from the intersection of social identities and positions among those who are oppressed multiple times. Among trans women, gender-based stigma intersects with social positions such as engagement in sex work and substance use, as well as race-based stigma to generate a social context of vulnerability and increased risk of HIV acquisition. In Brazil, trans women are the ‘most at-risk’ group for HIV, with 55 times higher estimated odds of HIV infection than the general population; further, uptake of HIV testing and pre-exposure prophylaxis (PrEP) among trans women is significantly lower than other at-risk groups. Through extensive formative work, we developed Manas por Manas, a multilevel intervention using HIV prevention strategies with demonstrated feasibility and acceptability by trans women in Brazil, to address intersectional stigma and increase engagement in the HIV prevention continuum.

Methods and analysis
We are conducting a two-arm randomised wait-list controlled trial of the intervention’s efficacy in São Paulo, Brazil, to improve uptake of HIV testing and PrEP among transgender women (N=400). The primary outcomes are changes in HIV testing (self-testing and clinic based), changes in PrEP uptake and changes in PrEP persistence at baseline and follow-up assessment for 12 months at 3-month intervals.

Ethics and dissemination
This study was approved by University of California, San Francisco Institutional Review Board (15-17910) and Comissão Nacional de Ética em Pesquisa (Research Ethics National Commission, CAAE: 25215219.8.0000.5479) in Brazil. Participants provided informed consent before enrolment. We are committed to collaboration with National Institutes of Health officials, other researchers, and health and social services communities for rapid dissemination of data and sharing of materials. The results will be published in peer-reviewed academic journals and scientific presentations.

Trial registration number
NCT03081559.

Boom di laureati nei prossimi anni, ma molte specializzazioni vanno deserte perché poco attrattive per stipendi e carriera e così una borsa su tre resta vuota

This Viewpoint calls for health care systems, oncologists, and staff to prioritize and adopt policies that are inclusive and respectful of transgender patients with cancer.

Frutto dell’accordo quadro tra l’Università di Milano, l’Aeronautica Militare e la Fondazione Ca’ Granda Ospedale Maggiore Policlinico, il Cemata si propone come esempio di think-tank civile-militare

Marti, ‘massima convergenza’ in Commissione Istruzione al Senato

This cross-sectional study compares emergency department use among transgender and gender-diverse as well as cisgender Medicare beneficiaries.

Transgender and gender-diverse (TGD) individuals are at a higher risk of developing physical and mental health conditions compared with their cisgender peers due to various reasons. These include avoiding health care (primary care and emergency care) due to persistent stigma, suboptimal access to high-quality mental health, lack of clinician knowledge and guidance to conduct appropriate evaluation and develop management plans, and lack of adequate documentation of TGD status in the ubiquitous electronic health records. Literature addressing the effects of these structural, process, and patient-level barriers has only started to emerge. Recent methodological advances, such as using TGD-specific diagnostic codes, have promoted the study of the health of TGD populations.