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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
Autore/Fonte: F. Lapi, D. Parretti
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.
Seduta del Consiglio Marche. Bassetti, nel 2003 salvò il pianeta
In Cdm lunedì. Più esami anche in telemedicina, gli esercizi in rete
Serve un sistema che integri i dati che arrivano da varie fonti
