Respond to your colleagues who were assigned a different patient than you. Criti

Respond to your colleagues who were assigned a different patient than you. Critique your colleagueâs targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.
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John Green presents himself in the office seeking primary care. He has transitioned from female within the last two years and has been receiving his testosterone from online purchases. He is also HIV positive and complies with his medication regimen using Telehealth services to attain his prescription medications. He smokes tobacco and marijuana and reports episodes of depression. He does not report any other medical history or family history. Some of his concerns are his financial status and his decline in health.
The patient presented in the case study has multiple factors that can be addressed in establishing a new patient interview. One of the patient’s major cultural factors is his transition from female to male. It is important to acknowledge his gender identity, and preference in pronouns should be considered. In addition, there are specific needs that this population of patients requires that others do not. Transgender patients are considered a social and health minority (Houssayni & Nilsen, 2018). Some needs include hormonal replacements and appropriate surgical and mental health services (Houssayni & Nilsen, 2018).
Other findings related to the transgender population are the incidence of HIV compared to other populations (Houssayni & Nilsen, 2018). This patient requires care for this diagnosis and routine lab work to check his viral load. In addition, along with the diagnosis and his gender identification, a societal stigma contributes to his mental health. The stigma and discrimination associated with HIV diagnosis and being part of the sexual minority increases the risk for stress and depressive episodes (Tabler et al., 2021).
No known interactions exist between hormonal injections for transitioning and antiretroviral medications (CDC, 2021). However, because the patient has been purchasing his medications from online sources, he is at risk of injecting himself with non-regulated substances. In addition, the use of testosterone injections should be closely monitored due to the possible side effects of inappropriate dosing. The overuse of the injections could be detrimental to a patient’s health (University of California, San Fransisco, 2020). An increased risk for stroke and other cardiac conditions is known due to an increased hematocrit when testosterone levels are too high (University of California, San Fransisco, 2020).
Finally, there are concerns about the patient’s financial status. The patient may face financial difficulties because he does not have a job. This could pose a challenge to adhering to medications or any testing that may be required.
With all the cultural factors presented, the patient requires individualized care. It is important to address his concerns that are unique to his situation. Social support is integral to the patient’s well-being. According to Tabler et al. (2021), healthcare providers should ensure that the patients receive the support services they require to deal with some of the stressors these patients experience.
The targeted questions that can be used to build this patient’s health history and assess for risks are:
Which pronouns do you prefer? What name would you prefer to use?
Who is your current provider for your Biktarvy? How often are you following up? (This question helps assess compliance with follow-up and ensure that the patient is not seeing multiple providers.)
What is your surgical history? (This question will help determine if the patient has had a hysterectomy or requires follow-up with a gynecologist.)
Are you currently sexually active? Which gender(s) do you prefer as sexual partners? (This question will determine risks for sexually transmitted diseases and risk for pregnancy if applicable.)
Do you feel safe living at home with your parents? Have you ever been a victim of any abuse? (This will determine if seeking housing is required. It will also help assess if the patient requires a referral for immediate social/emotional services.)
References
Ball, J., Dains, J., Flynn, J., Soloman, B., & Stewart, R. (2021). Seidel’s guide to physicalexamination 9th edition 2018(9th ed.). Elsevier.
Centers for Disease Control and Prevention (CDC). (2021, March 23). HIV Testing, prevention and care for transgender people. HIV Testing. https://www.cdc.gov/hiv/clinicians/transforming-health/health-care-providers/prevention-and-care-data.htmlLinks to an external site.
Houssayni, S., & Nilsen, K. (2018). Transgender competent provider: identifying transgender health needs, health disparities, and health coverage. Kansas journal of medicine, 11(1), 15.
Tabler, J., Mykyta, L., Schmitz, R. M., Kamimura, A., Martinez, D. A., Martinez, R. D., … & Torres, A. (2021). Getting by with a little help from our friends: The role of social support in addressing HIV-related mental health disparities among sexual minorities in the lower Rio Grande Valley. Journal of Homosexuality, 68(2), 269-289.
University of California-San Fransisco. (2020, July). Information on testosterone hormone therapy. Overview of Masculinizing Hormone Therapy. https://transcare.ucsf.edu/article/information-testosterone-hormone-therapyLinks to an external site.