Suchergebnisse

BACKGROUND: Coronavirus disease 2019 (COVID-19) has disproportionately affected communities of color, with black persons experiencing the highest rates of disease severity and mortality. A vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has the potential to reduce the race mortality gap from COVID-19; however, hesitancy toward the vaccine in the black community threatens vaccine uptake. METHODS: We conducted focus groups with black barbershop and salon owners living in zip codes of elevated COVID-19 prevalence to assess their attitudes, beliefs, and norms around a COVID-19 vaccine. We used a modified grounded theory approach to analyze the transcripts.RESULTS: We completed 4 focus groups (N = 24 participants) in July and August 2020. Participants were an average age of 46 years, and 89% were black non-Hispanic. Hesitancy against the COVID-19 vaccine was high due to mistrust in the medical establishment, concerns with the accelerated timeline for vaccine development, limited data on short- and long-term side effects, and the political environment promoting racial injustice. Some participants were willing to consider the vaccine once the safety profile is robust and reassuring. Receiving a recommendation to take the vaccine from a trusted healthcare provider served as a facilitator. Health beliefs identified were similar to concerns around other vaccines and included the fear of getting the infection with vaccination and preferring to improve one's baseline physical health through alternative therapies.CONCLUSIONS: We found that hesitancy of receiving the COVID-19 vaccine was high; however, provider recommendation and transparency around the safety profile might help reduce this hesitancy.SUMMARY: In focus group discussions, hesitancy of a COVID-19 vaccine was high among black participants due to health beliefs against vaccines in general, compounded by skepticism of vaccine development during the pandemic and the political environment fostering racial injustice.

INTRODUCTION: Coronavirus Disease 2019 (COVID-19) has disproportionately affected communities of color, with blacks experiencing the highest rates of disease severity and mortality. A vaccine against SARS-CoV-2 has the potential to reduce the race mortality gap from COVID-19; however, hesitancy of the vaccine in the black community threatens vaccine uptake. METHODS: We conducted focus groups with black barbershop and salon owners living in zip codes of elevated COVID-19 prevalence to assess their attitudes, beliefs, and norms around a COVID-19 vaccine. We used a modified grounded theory approach to analyze the transcripts. RESULTS: We completed four focus groups (n=24 participants) in July and August 2020. Participants were an average age of 46, 89% were black non-Hispanic. Hesitancy against the COVID-19 vaccine was high due to mistrust in the medical establishment, concerns with the accelerated timeline for vaccine development, limited data on short and long-term side effects, and the political environment promoting racial injustice. Some participants were willing to consider the vaccine once the safety profile is robust and reassuring. Receiving a recommendation to take the vaccine from a trusted health care provider served as a facilitator. Health beliefs identified were similar to concerns around other vaccines, and included the fear of getting the infection with vaccination, and preferring to improve one's baseline physical health through alternative therapies. CONCLUSION: We found that hesitancy of the COVID-19 vaccine was high; however, provider recommendation and transparency around the safety profile might help reduce hesitancy of the COVID-19 vaccine.

AbstractIntroductionCurrent implementation efforts have failed to achieve equitable HIV pre‐exposure prophylaxis (PrEP) provision for transgender and gender‐diverse (trans) populations. We conducted a choice‐based conjoint analysis to measure preferences for key attributes of hypothetical PrEP delivery programmes among a diverse online sample predominantly comprised of transmasculine and nonbinary individuals in the United States.MethodsBetween April 2022 and June 2022, a national online survey with an embedded conjoint analysis experiment was conducted among 304 trans individuals aged ≥18 years in the United States to assess five PrEP programme attributes: out‐of‐pocket cost; dispensing venue; frequency of visits for PrEP‐related care; travel time to PrEP provider; and ability to bundle PrEP‐related care with gender‐affirming hormone therapy services. Participants responded to five questions, each of which presented two PrEP programme scenarios and one opt‐out option per question and selected their preferred programme in each question. We used hierarchical Bayes estimation and multinomial logistic regression to measure part‐worth utility scores for the total sample and by respondents' PrEP status.ResultsThe median age was 24 years (range 18–56); 75% were assigned female sex at birth; 54% identified as transmasculine; 32% as nonbinary; 14% as transfeminine. Out‐of‐pocket cost had the highest attribute importance score (44.3%), followed by the ability to bundle with gender‐affirming hormone therapy services (18.7%). Minimal cost‐sharing ($0 out‐of‐pocket cost) most positively influenced the attribute importance of cost (average conjoint part‐worth utility coefficient of 2.5 [95% CI 2.4−2.6]). PrEP‐experienced respondents preferred PrEP delivery in primary care settings (relative utility score 4.7); however, PrEP‐naïve respondents preferred pharmacies (relative utility score 5.1).ConclusionsParticipants preferred programmes that offered PrEP services without cost‐sharing and bundled with gender‐affirming hormone therapy services. Bolstering federal regulations to cover PrEP services and prioritizing programmes to expand low‐barrier PrEP provision are critical to achieving equitable PrEP provision. Community‐engaged implementation research conducted by and in close collaboration with trans community stakeholders and researchers are needed to streamline the design of patient‐centred PrEP programmes and develop implementation strategies that are salient to the diverse sexual health needs of trans patients.