scholarly journals Evidence for the Model of Gender Affirmation: The Role of Gender Affirmation and Healthcare Empowerment in Viral Suppression Among Transgender Women of Color Living with HIV

2019 ◽  
Author(s):  
Jae Sevelius ◽  
◽  
Deepalika Chakravarty ◽  
Torsten B. Neilands ◽  
JoAnne Keatley ◽  
...  
Keyword(s):  
Women Of Color ◽  
Viral Suppression ◽  
Transgender Women ◽  
Gender Affirmation ◽  
Healthcare Empowerment ◽  
Living With Hiv

scholarly journals Biopsychosocial Mechanisms Linking Gender Minority Stress to HIV Comorbidities Among Black and Latina Transgender Women (LITE Plus): Protocol for a Mixed Methods Longitudinal Study

10.2196/17076 ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. e17076 ◽  
Author(s):  
Ashleigh J Rich ◽  
Jennifer Williams ◽  
Mannat Malik ◽  
Andrea Wirtz ◽  
Sari Reisner ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Disparities ◽  
Mixed Methods ◽  
Longitudinal Study ◽  
Survey Data ◽  
Chronic Stress ◽  
Transgender Women ◽  
Stigma And Discrimination ◽  
Living With Hiv

Background Black and Latina transgender women (TW) experience a disparate burden of HIV and related comorbidities, including poor mental health and cardiovascular disease (CVD) risks. Pervasive multilevel stigma and discrimination operate as psychosocial stressors for TW living with HIV and shape health disparities for this population. Gender-affirming hormone therapy (GAHT) is commonly used by TW to facilitate alignment of the body with gender identity; in the context of stigma, GAHT may both improve mental health and increase CVD risks. Objective This study aims to quantify the longitudinal relationship between stigma and chronic stress among black and Latina TW living with HIV. Secondary objectives include identifying pathways linking chronic stress to HIV comorbidities and exploring chronic stress as a mediator in the pathway linking stigma and GAHT to CVD comorbidities. Methods This US-based mixed methods longitudinal study will enroll a prospective cohort of 200 black and Latina TW living with HIV, collecting quantitative survey data, qualitative interviews, and biomarkers of chronic stress. Interviewer-administered surveys will include validated psychosocial measures of self-reported stigma and discrimination, perceived stress, CVD risk factors, mental health, access to gender-affirming care, coping, and social support. Medical record abstraction will collect data on GAHT use, CD4 count, HIV viral load, antiretroviral therapy, treatment, and comorbid conditions. Clinical measures will include physiological biomarkers as well as salivary and blood-based biomarkers of chronic stress. Survey data will be collected every 6 months (baseline, and 6, 12, 18, and 24 months), and biospecimens will be collected at baseline and at 12 and 24 months. A purposive subsample (stratified by use of GAHT and presence of depressive symptoms) of 20 to 30 TW living with HIV will be invited to participate in in-depth interviews at 6 and 18 months to explore experiences of intersectional stigma, chronic stress, and the role of GAHT in their lives. Results This study was funded by the National Institute on Minority Health and Health Disparities in December 2018. The study community advisory board and scientific advisors provided critical input on study design. Recruitment began in October 2019 (n=29 participants as of submission) and data collection will continue through 2022, with publication of baseline results anticipated summer 2021. Conclusions This study will focus on black and Latina TW living with HIV, an understudied health disparities population, advance both stigma and intersectionality research, and move chronic stress physiology research toward a more nuanced understanding of sex and gender. The comprehensive methodology will support the exploration of the role of exogenous estrogen in the pathways between stress and HIV comorbidities, elucidating the role of GAHT in the stress-health relationship. Finally, this study will provide longitudinal evidence of the impact of stigma-related chronic stress on the lives of black and Latina TW living with HIV integrating qualitative and quantitative data with psychosocial, clinical, and biological measures. International Registered Report Identifier (IRRID) DERR1-10.2196/17076

scholarly journals Integration of Gender-Affirming Primary Care and Peer Navigation With HIV Prevention and Treatment Services to Improve the Health of Transgender Women: Protocol for a Prospective Longitudinal Cohort Study (Preprint)

2019 ◽  
Author(s):  
Javier R Lama ◽  
Kenneth H Mayer ◽  
Amaya G Perez-Brumer ◽  
Leyla Huerta ◽  
Hugo Sanchez ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Hiv Prevention ◽  
Hormone Therapy ◽  
Transgender Women ◽  
Treatment Services ◽  
Prevention And Treatment ◽  
Gender Affirmation ◽  
Peer Navigation ◽  
Living With Hiv

BACKGROUND Public health strategies are urgently needed to improve HIV disparities among transgender women, including holistic intervention approaches that address those health needs prioritized by the community. Hormone therapy is the primary method by which many transgender women medically achieve gender affirmation. Peer navigation has been shown to be effective to engage and retain underserved populations living with HIV in stable primary medical care. OBJECTIVE This study aims to assess the feasibility and acceptability of an integrated innovative HIV service delivery model designed to improve HIV prevention and care by combining gender-affirming primary care and peer navigation with HIV prevention and treatment services. METHODS A 12-month, nonrandomized, single-arm cohort study was implemented in Lima, Peru, among adult individuals, assigned a male sex at birth, who identified themselves as transgender women, regardless of initiation or completion of medical gender affirmation, and who were unaware of their HIV serostatus or were living with HIV but not engaged in HIV treatment. HIV-negative participants received quarterly HIV testing and were offered to initiate pre-exposure prophylaxis. HIV-positive participants were offered to initiate antiretroviral treatment and underwent quarterly plasma HIV-1 RNA and peripheral CD4+ lymphocyte cell count monitoring. All participants received feminizing hormone therapy and adherence counseling and education on their use. Peer health navigation facilitated retention in care by visiting participants at home, work, or socialization venues, or by contacting them by social media and phone. RESULTS Patient recruitment started in October 2016 and finished in March 2017. The cohort ended follow-up on March 2018. Data analysis is currently underway. CONCLUSIONS Innovative and culturally sensitive strategies to improve access to HIV prevention and treatment services for transgender women are vital to curb the burden of HIV epidemic for this key population. Findings of this intervention will inform future policies and research, including evaluation of its efficacy in a randomized controlled trial. CLINICALTRIAL ClinicalTrials.gov NCT03757117; https://clinicaltrials.gov/ct2/show/NCT03757117 INTERNATIONAL REGISTERED REPOR DERR1-10.2196/14091

Role of Support Reciprocity in HIV Viral Suppression Among People Living with HIV and Their Treatment Partners in Botswana

2021 ◽  
Author(s):  
Laura M. Bogart ◽  
Nthabiseng Phaladze ◽  
Harold D. Green ◽  
David J. Klein ◽  
Keonayang Kgotlaetsile ◽  
...  
Keyword(s):  
Viral Suppression ◽  
People Living With Hiv ◽  
Hiv Viral Suppression ◽  
Living With Hiv

scholarly journals Meeting the needs of young Latino gay, bisexual, and other men who have sex with men (MSM) and transgender women living with HIV through the weCare intervention in the United State (U.S.)

2021 ◽  
pp. 209-232
Author(s):  
Jorge Alonzo ◽  
◽  
Lilli Mann-Jackson ◽  
Jesús García ◽  
Amanda E. Tanner ◽  
...  
Keyword(s):  
Social Media ◽  
Viral Suppression ◽  
The United States ◽  
Transgender Women ◽  
Lessons Learned ◽  
Hiv Care ◽  
Media Messages ◽  
Women Living With Hiv ◽  
Sex With Men ◽  
Living With Hiv

Young gay, bisexual, and other MSM (men who have sex with men) and transgender women in the United States (US) who are living with HIV, and particularly those who are Latino, have low rates of viral suppression. The weCare intervention uses social media to increase HIV care engagement. Method: We used community-based participatory research to develop the intervention as well as theory-based social media messages tailored to each participant’s unique context. We analyzed elements and characteristics of weCare, messages sent by the Cyber Health Educator (CHE), and lessons learned to meet the needs of Latino participants living with HIV. Results: We identified 6 core elements, 5 key characteristics, effective social media messages used in implementation, and 8 important lessons regarding relationships between the CHE and HIV clinics, the CHE and participants, and participants and the health system. Conclusions: Social media offers a promising platform to retain young Latino gay bisexual and other MSM and transgender women living with HIV in care and achieve viral suppression.

scholarly journals The role of gender affirmation in psychological well-being among transgender women.

2016 ◽  
Vol 3 (3) ◽  
pp. 336-344 ◽  
Author(s):  
Tiffany R. Glynn ◽  
Kristi E. Gamarel ◽  
Christopher W. Kahler ◽  
Mariko Iwamoto ◽  
Don Operario ◽  
...  
Keyword(s):  
Well Being ◽  
Transgender Women ◽  
Psychological Well Being ◽  
Gender Affirmation
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