Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot

Abstract Background Transgender (trans) women face constrained access to gender-affirming HIV prevention and care. This is fueled in part by the convergence of limited trans knowledge and competency with anti-trans and HIV-related stigmas among social and healthcare providers. To advance gender-affi...

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Autores principales:	Ashley Lacombe-Duncan, Carmen H. Logie, Yasmeen Persad, Gabrielle Leblanc, Kelendria Nation, Hannah Kia, Ayden I. Scheim, Tara Lyons, Chavisa Horemans, Ronke Olawale, Mona Loutfy
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Transgender Stigma Health care Provider Social services HIV prevention Special aspects of education LC8-6691 Medicine R
Acceso en línea:	https://doaj.org/article/401335a607ec45e68d76e54d3b19487b
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spelling	oai:doaj.org-article:401335a607ec45e68d76e54d3b19487b2021-11-08T11:17:29ZImplementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot10.1186/s12909-021-02991-31472-6920https://doaj.org/article/401335a607ec45e68d76e54d3b19487b2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12909-021-02991-3https://doaj.org/toc/1472-6920Abstract Background Transgender (trans) women face constrained access to gender-affirming HIV prevention and care. This is fueled in part by the convergence of limited trans knowledge and competency with anti-trans and HIV-related stigmas among social and healthcare providers. To advance gender-affirming HIV service delivery we implemented and evaluated ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’. This theoretically-informed community-developed intervention aimed to increase providers’ gender-affirming HIV prevention and care knowledge and competency and reduce negative attitudes and biases among providers towards trans women living with and/or affected by HIV. Methods Healthcare and social service providers and providers in-training (e.g., physicians, nurses, social workers) working with trans women living with and/or affected by HIV (n = 78) participated in a non-randomized multi-site pilot study evaluating TEACHH with a pre-post-test design. Pre- and post-intervention surveys assessed participant characteristics, intervention feasibility (e.g., workshop completion rate) and acceptability (e.g., willingness to attend another training). Paired sample t-tests were conducted to assess pre-post intervention differences in perceived competency, attitudes/biases, and knowledge to provide gender-affirming HIV care to trans women living with HIV and trans persons. Results The intervention was feasible (100% workshop completion) and acceptable (91.9% indicated interest in future gender-affirming HIV care trainings). Post-intervention scores indicated significant improvement in: 1) knowledge, attitudes/biases and perceived competency in gender-affirming HIV care (score mean difference (MD) 8.49 (95% CI of MD: 6.12–10.86, p < 0.001, possible score range: 16–96), and 2) knowledge, attitudes/biases and perceived competency in gender-affirming healthcare (MD = 3.21; 95% CI of MD: 1.90–4.90, p < 0.001, possible score range: 9–63). Greater change in outcome measures from pre- to post-intervention was experienced by those with fewer trans and transfeminine clients served in the past year, in indirect service roles, and having received less prior training. Conclusions This brief healthcare and social service provider intervention showed promise in improving gender-affirming provider knowledge, perceived competency, and attitudes/biases, particularly among those with less trans and HIV experience. Scale-up of TEACHH may increase access to gender-affirming health services and HIV prevention and care, increase healthcare access, and reduce HIV disparities among trans women. Trial registration ClinicalTrials.gov ( NCT04096053 ).Ashley Lacombe-DuncanCarmen H. LogieYasmeen PersadGabrielle LeblancKelendria NationHannah KiaAyden I. ScheimTara LyonsChavisa HoremansRonke OlawaleMona LoutfyBMCarticleTransgenderStigmaHealth careProviderSocial servicesHIV preventionSpecial aspects of educationLC8-6691MedicineRENBMC Medical Education, Vol 21, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Transgender Stigma Health care Provider Social services HIV prevention Special aspects of education LC8-6691 Medicine R
spellingShingle	Transgender Stigma Health care Provider Social services HIV prevention Special aspects of education LC8-6691 Medicine R Ashley Lacombe-Duncan Carmen H. Logie Yasmeen Persad Gabrielle Leblanc Kelendria Nation Hannah Kia Ayden I. Scheim Tara Lyons Chavisa Horemans Ronke Olawale Mona Loutfy Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot
description	Abstract Background Transgender (trans) women face constrained access to gender-affirming HIV prevention and care. This is fueled in part by the convergence of limited trans knowledge and competency with anti-trans and HIV-related stigmas among social and healthcare providers. To advance gender-affirming HIV service delivery we implemented and evaluated ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’. This theoretically-informed community-developed intervention aimed to increase providers’ gender-affirming HIV prevention and care knowledge and competency and reduce negative attitudes and biases among providers towards trans women living with and/or affected by HIV. Methods Healthcare and social service providers and providers in-training (e.g., physicians, nurses, social workers) working with trans women living with and/or affected by HIV (n = 78) participated in a non-randomized multi-site pilot study evaluating TEACHH with a pre-post-test design. Pre- and post-intervention surveys assessed participant characteristics, intervention feasibility (e.g., workshop completion rate) and acceptability (e.g., willingness to attend another training). Paired sample t-tests were conducted to assess pre-post intervention differences in perceived competency, attitudes/biases, and knowledge to provide gender-affirming HIV care to trans women living with HIV and trans persons. Results The intervention was feasible (100% workshop completion) and acceptable (91.9% indicated interest in future gender-affirming HIV care trainings). Post-intervention scores indicated significant improvement in: 1) knowledge, attitudes/biases and perceived competency in gender-affirming HIV care (score mean difference (MD) 8.49 (95% CI of MD: 6.12–10.86, p < 0.001, possible score range: 16–96), and 2) knowledge, attitudes/biases and perceived competency in gender-affirming healthcare (MD = 3.21; 95% CI of MD: 1.90–4.90, p < 0.001, possible score range: 9–63). Greater change in outcome measures from pre- to post-intervention was experienced by those with fewer trans and transfeminine clients served in the past year, in indirect service roles, and having received less prior training. Conclusions This brief healthcare and social service provider intervention showed promise in improving gender-affirming provider knowledge, perceived competency, and attitudes/biases, particularly among those with less trans and HIV experience. Scale-up of TEACHH may increase access to gender-affirming health services and HIV prevention and care, increase healthcare access, and reduce HIV disparities among trans women. Trial registration ClinicalTrials.gov ( NCT04096053 ).
format	article
author	Ashley Lacombe-Duncan Carmen H. Logie Yasmeen Persad Gabrielle Leblanc Kelendria Nation Hannah Kia Ayden I. Scheim Tara Lyons Chavisa Horemans Ronke Olawale Mona Loutfy
author_facet	Ashley Lacombe-Duncan Carmen H. Logie Yasmeen Persad Gabrielle Leblanc Kelendria Nation Hannah Kia Ayden I. Scheim Tara Lyons Chavisa Horemans Ronke Olawale Mona Loutfy
author_sort	Ashley Lacombe-Duncan
title	Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot
title_short	Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot
title_full	Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot
title_fullStr	Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot
title_full_unstemmed	Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot
title_sort	implementation and evaluation of the ‘transgender education for affirmative and competent hiv and healthcare (teachh)’ provider education pilot
publisher	BMC
publishDate	2021
url	https://doaj.org/article/401335a607ec45e68d76e54d3b19487b
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Implementation and evaluation of the ‘Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)’ provider education pilot

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