Implementation Strategies for Creating Inclusive, All-Women HIV Care Environments: Perspectives From Trans and Cis Women

Moving toward equity: fostering transdisciplinary research between the social and behavioral sciences and implementation science to end the HIV epidemic

“…Meaningful community participation is a key characteristic of transdisciplinary research. Although both SBS and IS engage community stakeholders in research, numerous scholars in each discipline have called for greater involvement of PWH [44 ▪▪ ,60,101,102 ▪▪ ,104,105,106 ▪ ,107 ▪▪ ], and we agree. In one of the few community-engaged studies to use an IS TMF, Harkness et al [44 ▪▪ ] conducted CFIR-guided interviews with cisgender Latino sexual minority men to identify determinants and implementation strategies for integrating behavioral health and HIV-prevention services.…”

“…We found both promise and room for growth here. For example, whereas some scholars used an IS framework to develop strategies [44 ▪▪ ,48 ▪▪ ], others did not [59 ▪▪ ,60–62]. Addressing a key gap, several studies [21 ▪▪ ,22 ▪▪ ,24 ▪▪ ,41 ▪▪ ,59 ▪▪ ] mapped implementation strategies to the Expert Recommendations for Implementing Change, which established conceptual clarity for 73 strategies [55].…”

“…In one of the few community-engaged studies to use an IS TMF, Harkness et al [44 ▪▪ ] conducted CFIR-guided interviews with cisgender Latino sexual minority men to identify determinants and implementation strategies for integrating behavioral health and HIV-prevention services. However, other community-engaged studies that included relevant SBS TMFs did not employ an IS framework [60–62,102 ▪▪ ,106 ▪ ,108]. This is a missed opportunity, as SBS-IS collaborations utilizing CBPR methods can ensure community input throughout the implementation process.…”

Determinants of Pre-exposure Prophylaxis (PrEP) Implementation in Transgender Populations: A Qualitative Scoping Review

“…Integrating gender affirmation surgery and PrEP may also serve to increase uptake by overcoming transportation burdens and time constraints, as well as integrating PrEP care into health care that is outwardly inclusive and aware of transgender individuals’ health needs (Sevelius, Deutsch, et al, 2016). Developing ongoing training and education and hiring transgender women can also help to cultivate organizations, clinics, and healthcare facilities with climates that are open and affirmative of transgender individuals and thus increase sustained engagement with transgender patients (Auerbach et al, 2021 ). Connecting already trialed implementation strategies, such as these with specified determinants, may facilitate PrEP uptake and adherence.…”

“…Such studies would categorize by gender rather than sex assigned at birth and would better represent gendered dynamics of individuals’ social ecologies that shape their health behaviors and experiences. Examples of such research can be found in some implementation strategies and interventions trials, including Walters et al’s ( 2021 ) implementation of a PrEP intervention for cisgender and transgender women and Auerbach et al’s ( 2021 ) interviews with cisgender and transgender women on developing HIV care for all women. It must be noted, though, that limited sub-samples of transgender individuals within samples lumping cisgender MSM and transgender women is not unique to implementation science.…”