Exploring barriers and facilitators to PrEP use among transgender women in two urban areas: implications for messaging and communication

Background Trans women are at increased risk for HIV infection yet are less likely to use pre-exposure prophylaxis (PrEP) medication as a preventive measure. PrEP messaging and marketing has focused on men who have sex with men (MSM) or included trans women as a subset of MSM, ignoring the potential barriers to PrEP use unique to trans women. Little is known about how this group conceptualizes PrEP, what knowledge gaps still exist, and how trans women believe PrEP should be communicated to increase use. Methods This qualitative study conducted focus groups (n = 5) in Philadelphia and Sacramento with trans women to assess these issues. Results Twelve sub-themes were found related to five main domains, including PrEP knowledge, benefits, barriers, community-related considerations, and messaging/marketing. Findings indicate that knowledge of PrEP is still low and beliefs about PrEP’s effects on hormone use persist. Most importantly, participants voiced a demand for culturally appropriate trans-specific messages in HIV prevention interventions and communication. Conclusions Without acknowledging specific barriers to PrEP uptake among transgender women separate from those of MSM and incorporating gender affirmation into PrEP education, simply knowing PrEP is available may not motivate trans women to use PrEP. This has important implications for future efforts to communicate about PrEP with trans women.

Development and Psychometric Evaluation of the Gender Identity Scale for Transgender Women in China

Transgender women are an important subgroup of the transgender umbrella and have their own unique gender identity. This article aimed to understand and measure the latent concept of gender identity among Chinese transgender women from a multi-dimensional perspective. Through a two-phase, iterative scale development process, we developed the Gender Identity Scale for Transgender Women (GIS-TW) in Chinese. Literature reviews, expert consultations, and focus groups constitute phrase 1 of the study, which resulted in the first version of GIS-TW with 30 items. In phrase 2, exploratory factor analysis on a sample of 244 Chinese transgender women revealed a six-factor solution across the 22 items. The Bem Sex Role Inventory was included to test for convergent validity, and the Rosenberg Self-Esteem Scale was used to test discriminant validity. Then we conducted the confirmatory factor analysis with an independent sample of 420 Chinese transgender women, which produced the final version of GIS-TW with 21 items. The internal consistency (Cronbach’s alpha = 0.71–0.87) and test-retest stability (r = 0.73–0.87) of each factor was good. In conclusion, the GIS-TW is a reliable and valid psychometric tool for the assessment of Chinese transgender women’s gender identity. Future application of the scale will help transgender women obtain better gender confirmative interventions.

Oral estrogen leads to falsely low concentrations of estradiol in a common immunoassay

Objectives: Recently, an estradiol immunoassay manufacturer (Beckman Coulter, USA) issued an “Important Product Notice” alerting clinical laboratories their assay (Access Sensitive Estradiol) was not indicated for patients undergoing exogenous estradiol treatment. The objective of this analysis was to evaluate immunoassay bias relative to liquid chromatography tandem mass spectrometry (LC-MS/MS) in transgender women and to examine the influence of unconjugated estrone on measurements. Design: Cross sectional secondary analysis. Methods: Estradiol concentrations from 89 transgender women were determined by three immunoassays (Access Sensitive Estradiol [‘New BC’] and Access Estradiol assays [‘Old BC’], Beckman Coulter; Estradiol III assay [‘Roche’], Roche Diagnostics) and LC-MS/MS. Bias was evaluated with and without adjustment for estrone concentrations. The number of participants who shifted between three estradiol concentration ranges for each immunoassay versus LC-MS/MS (>300 pg/mL, 70-300 pg/mL, and <70 pg/mL) was calculated. Results: The New BC assay had the largest magnitude overall bias (median: -34%) and was -40%, -22%, and -10%, among participants receiving tablet, patch, or injection preparations, respectively. Overall bias was -12% and +17% for the Roche and Old BC assays, respectively. When measured with the New BC assay, 18 participants shifted to a lower estradiol concentration range (versus 9 and 10 participants based on Roche or Old BC assays, respectively). Adjustment for estrone did not minimize bias. Conclusions: Immunoassay measurement of estradiol in transgender women may lead to falsely decreased concentrations that have the potential to affect management. A multi-disciplinary health care approach is needed to ensure appropriate analytical methods are available.

KONSEP DIRI WARIA (FENOMENA WARIA DI AKADEMI PARIWISATA MAKASSAR)

ABSTRACTThis study aims to describe the self-concept of the transgender and the process of forming the self-concept of the transgender. The data analysis of the research results was carried out qualitatively. The approach used is a phenomenological approach, where the subjects studied are transgender women who study at the Makassar Tourism Academy. The results of the study prove that Subject 1 (NN) and subject 2 (OP) have a negative self-concept because they are unable to position themselves as a whole, being male or female. After all, they can play two genders at once, confusing gender, while 3 (ED) has a positive self-concept because the subject is positive about him.Keywords : self-concept, transgender ABSTRAKPenelitian ini bertujuan untuk mendiskripsikan konsep diri kaum waria dan proses pembentukan konsep diri kaum waria. Analisis data hasil penelitian dilakukan secara kualitatif. Pendekatan yang digunakan adalah pendekatan fenomenologi, dimana subjek yang diteliti adalah waria yang kuliah di Akademi Pariwisata Makassar. Hasil penelitian membuktikan bahwa Subjek 1 (NN) dan subjek 2 (OP) memiliki konsep diri yang cenderung negatif dikarenakan belum mampu memposisikan diri seutuhnya menjadi laki-laki atau perempuan karena mampu memerankan dua jenis kelamin sekaligus dalam kehidupannya sehingga mengalami kebingungan identitas jenis kelamin, sementara subjek 3 (ED) memiliki konsep diri yang cenderung positif dikarenakan penilaian positif terhadap dirinya.

VARIASI JARGON DALAM SUATU KOMUNITAS WARIA DI SALON RETHAH WILAYAH PONDOK BENDA

Language has an important role in everyday human life in society. Jargon is a kind of language that is only used by certain communities as daily communication among its members. The jargon used by the transgender community is very interesting to understand because the jargon has its own form and meaning in its disclosure and can find out how the variety of jargon-shaped language used by transgenders in hiding their secrets so as not to be known by the public. It is evident that not all users of other languages understand the jargon. In this study, the researchers analyzed the jargon used by the waria community in the salon. This study aims to determine the jargon and describe and understand the meaning of the jargon used by the transgender community in interacting orally. The source of the research data was obtained from the subject, namely the transgender women who worked at the Retah salon in Pamulang, who used jargon in their daily communication with transgender women and sometimes with their customers. The method used in this study is a qualitative descriptive method, which describes and conveys data objectively. Describe the jargon terms of transgender language as the object of research. The data collection technique used is observation or see and note. The result of this research is the jargon used by waria in the form of transgender language vocabulary. Based on the results of the data analysis, it was found that 20 pieces of jargon used by transgender women in the salon were akika, rapose, capcus, endang gurindang, ink, sekong, belenjong, cucok, metong, hamidah, lekong, sapose, capcay, begindang, bala-bala, sindang. , lambreta, grasshopper, mesong, and mursida.Keywords: Waria, Jargon, Vocabulary

PENGUATAN ODHA TRANSPUAN KOTA DENPASAR DAN BULELENG DALAM KESEHATAN MASYARAKAT PEDULI WARIA

ABSTRACT This workshop on strengthening Transwomen with HIV/Aids (ODHAT) started from the issue of discrimination that often afflicts the LGBT and ODHATgroups. Transgender women or better known as waria are gender transfers from male to female. They are often embarrassed or humiliated to take part in society {especially for ODHA (People with HIV/Aids)}. In the city of Singaraja, Wargas have been formed as Transwomen organization that is actively developing their social and cultural capital in the community. Denpasar City has three units of official outreach institutions for LGBT, namely Gaya Dewata, Kerti Praja Foundation and Spirit Paramacita. The number of Transwomen with ODHA in Denpasar City is estimated at 40 people and in Singaraja City it is estimated at 11 people. They need to be protected from the stigma of society in other reachable and social media so that their communication patterns are more conducive and the community is more accepting of their existence. The 5-hour Tengkuluk Lelunakan make-up training was carried out by presenting the Warcan and Perwaron groups at Salon Agung on July 13, 2019. Ibu Agung as a salon owner who is famous for Payas Agung and Tengkuluk Lelunakan has facilitated them to learn tengkuluk lelunakan make-up. Denpasar city transgender groups are facilitated to perform in cultural events or other festivals, as has been done by Wargas in Singaraja city. However, correspondence with the Head of the Bali Provincial Culture Service in the office and with the initiator of the Sanur Village Festival at the Griya Santrian hotel has not produced results. The tengkuluk Lelunakan workshop for transwomen with ODHA aims to make the community accept them and finally be able to get access to various facilities to perform in public areas, especially in festivals in the city of Denpasar. Keywords: transwomen, ODHAT, LGBT discrimination, Denpasar, Singaraja