2023-09-28 14:46:10 +00:00
|
|
|
abstract: 'Background Transgender women ({''''}trans women{''''}), particularly
|
|
|
|
|
|
|
|
|
|
African-American and Latina trans women, have disproportionately high
|
|
|
|
|
|
|
|
|
|
prevalence of HIV in the United States (U.S.). In order to decrease
|
|
|
|
|
|
|
|
|
|
gender dysphoria and overcome discrimination, trans women affirm their
|
|
|
|
|
|
|
|
|
|
gender through social and medical transition, often in contexts of
|
|
|
|
|
|
|
|
|
|
economic hardship and sexual risk. This study qualitatively examined how
|
|
|
|
|
|
|
|
|
|
gender-affirming behaviors enhance or diminish vulnerability to HIV in
|
|
|
|
|
|
|
|
|
|
light of structural and economic barriers to gender transition. Methods
|
|
|
|
|
|
|
|
|
|
We conducted individual interviews with 19 adult trans women in two U.S.
|
|
|
|
|
|
|
|
|
|
cities (Richmond, VA and St. Louis, MO) who reported one or more sexual
|
|
|
|
|
|
|
|
|
|
risk behaviors and recent economic hardship related to
|
|
|
|
|
|
|
|
|
|
employment/income, housing, or food security. Interviews were recorded,
|
|
|
|
|
|
|
|
|
|
transcribed, and analyzed using thematic content analysis. Results The
|
|
|
|
|
|
|
|
|
|
majority (74\%) of trans women were racial/ethnic minorities with mean
|
|
|
|
|
|
|
|
|
|
age of 26.3 years. Gender-affirming behaviors varied with 58\% of trans
|
|
|
|
|
|
|
|
|
|
women having legally changed their name and gender marker; 79\% having
|
|
|
|
|
|
|
|
|
|
initiated hormone therapy; and 11\% having not initiated any medical or
|
|
|
|
|
|
|
|
|
|
legal changes. None had undertaken surgical changes. Findings suggested
|
|
|
|
|
|
|
|
|
|
that the process of gender transitioning resulted in both increasing and
|
|
|
|
|
|
|
|
|
|
decreasing HIV risk. The high need for gender affirmation by male sex
|
|
|
|
|
|
|
|
|
|
partners contributed to trans women''s exposure to sexual
|
|
|
|
|
|
|
|
|
|
objectification, sexual risk behaviors, and conflicting interests in HIV
|
|
|
|
|
|
|
|
|
|
prevention messaging. Loss of housing and employment due to transition
|
|
|
|
|
|
|
|
|
|
along with the high costs of transition products and medical visits
|
|
|
|
|
|
|
|
|
|
increased reliance on sex work and created new obstacles in accessing
|
|
|
|
|
|
|
|
|
|
HIV services. Trans women experienced lower HIV risk as they acquired
|
|
|
|
|
|
|
|
|
|
legal and medical transition services, reshaped interactions with sex
|
|
|
|
|
|
|
|
|
|
partners, and received gender-affirming support by others, including
|
|
|
|
|
|
|
|
|
|
health providers, employers, peers, and housing professionals. Sexual
|
|
|
|
|
|
|
|
|
|
abstinence was viewed as a negative consequence of incomplete
|
|
|
|
|
|
|
|
|
|
transition, although characterized as a period of low HIV risk.
|
|
|
|
|
|
|
|
|
|
Conclusions Structural and policy initiatives that promote safe gender
|
|
|
|
|
|
|
|
|
|
transition and economic stability in trans women may play a critical
|
|
|
|
|
|
|
|
|
|
role in reducing HIV in this population. Addressing the harmful
|
|
|
|
|
|
|
|
|
|
pressures for U.S. trans women to conform to perceived feminine
|
|
|
|
|
|
|
|
|
|
stereotypes may also serve an important role.'
|
|
|
|
|
affiliation: 'Mayo-Wilson, LJ (Corresponding Author), Indiana Univ, Ctr Sexual Hlth
|
|
|
|
|
Promot, Dept Appl Hlth Sci, Sch Publ Hlth, 1025 E 7th St, Bloomington, IN 47405
|
|
|
|
|
USA.
|
|
|
|
|
|
|
|
|
|
Mayo-Wilson, LJ (Corresponding Author), Johns Hopkins Bloomberg Sch Publ Hlth, Dept
|
|
|
|
|
Int Hlth, Social \& Behav Intervent Program, 615 N Wolfe St,Room E5038, Baltimore,
|
|
|
|
|
MD 21205 USA.
|
|
|
|
|
|
|
|
|
|
Mayo-Wilson, Larissa Jennings; Wagner, Sarah; Timbo, Fatmata, Indiana Univ, Ctr
|
|
|
|
|
Sexual Hlth Promot, Dept Appl Hlth Sci, Sch Publ Hlth, 1025 E 7th St, Bloomington,
|
|
|
|
|
IN 47405 USA.
|
|
|
|
|
|
|
|
|
|
Mayo-Wilson, Larissa Jennings, Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth,
|
|
|
|
|
Social \& Behav Intervent Program, 615 N Wolfe St,Room E5038, Baltimore, MD 21205
|
|
|
|
|
USA.
|
|
|
|
|
|
|
|
|
|
Benotsch, Eric G.; Sawyer, Ashlee N.; Smout, Shelby A., Virginia Commonwealth Univ,
|
|
|
|
|
Dept Psychol, 806 West Franklin St, Richmond, VA 23284 USA.
|
|
|
|
|
|
|
|
|
|
Grigsby, Sheila; Cathers, Lauretta, Univ Missouri, Coll Nursing, 221 NAB South Campus,Univ
|
|
|
|
|
Blvd, St Louis, MO 63121 USA.
|
|
|
|
|
|
|
|
|
|
Poteat, Tonia, Univ N Carolina, Dept Social Med, CB 7240, Chapel Hill, NC 27516
|
|
|
|
|
USA.
|
|
|
|
|
|
|
|
|
|
Zimmerman, Rick S., Louisiana State Univ Hlth New Orleans, Sch Nursing, 1900 Gravier
|
|
|
|
|
St,Room 5B14, New Orleans, LA 70112 USA.'
|
|
|
|
|
article-number: '782'
|
|
|
|
|
author: Mayo-Wilson, Larissa Jennings and Benotsch, Eric G. and Grigsby, Sheila and
|
|
|
|
|
Wagner, Sarah and Timbo, Fatmata and Poteat, Tonia and Cathers, Lauretta and Sawyer,
|
|
|
|
|
Ashlee N. and Smout, Shelby A. and Zimmerman, Rick S.
|
|
|
|
|
author-email: ljmayowi@iu.edu
|
|
|
|
|
author_list:
|
|
|
|
|
- family: Mayo-Wilson
|
|
|
|
|
given: Larissa Jennings
|
|
|
|
|
- family: Benotsch
|
|
|
|
|
given: Eric G.
|
|
|
|
|
- family: Grigsby
|
|
|
|
|
given: Sheila
|
|
|
|
|
- family: Wagner
|
|
|
|
|
given: Sarah
|
|
|
|
|
- family: Timbo
|
|
|
|
|
given: Fatmata
|
|
|
|
|
- family: Poteat
|
|
|
|
|
given: Tonia
|
|
|
|
|
- family: Cathers
|
|
|
|
|
given: Lauretta
|
|
|
|
|
- family: Sawyer
|
|
|
|
|
given: Ashlee N.
|
|
|
|
|
- family: Smout
|
|
|
|
|
given: Shelby A.
|
|
|
|
|
- family: Zimmerman
|
|
|
|
|
given: Rick S.
|
|
|
|
|
da: '2023-09-28'
|
|
|
|
|
doi: 10.1186/s12889-020-08902-3
|
|
|
|
|
eissn: 1471-2458
|
|
|
|
|
files: []
|
|
|
|
|
journal: BMC PUBLIC HEALTH
|
|
|
|
|
keywords: 'Transgender women; Housing; Employment; Economic; Qualitative; U; s;
|
|
|
|
|
|
|
|
|
|
HIV; Minority'
|
|
|
|
|
keywords-plus: RISK BEHAVIORS; SEX WORK; MEN; FRAMEWORK; HIV/STI; HEALTH; DRUGS
|
|
|
|
|
language: English
|
|
|
|
|
month: MAY 26
|
|
|
|
|
number: '1'
|
|
|
|
|
number-of-cited-references: '41'
|
|
|
|
|
papis_id: 36fb7e58a393d4015d74b10963106225
|
|
|
|
|
ref: Mayowilson2020combinedeffects
|
|
|
|
|
researcherid-numbers: 'Smout, Shelby/AHD-7847-2022
|
|
|
|
|
|
|
|
|
|
Sawyer, Ashlee/AAI-3584-2021'
|
|
|
|
|
times-cited: '18'
|
|
|
|
|
title: 'Combined effects of gender affirmation and economic hardship on vulnerability
|
|
|
|
|
to HIV: a qualitative analysis among US adult transgender women'
|
2023-10-01 08:15:07 +00:00
|
|
|
type: article
|
2023-09-28 14:46:10 +00:00
|
|
|
unique-id: WOS:000537860400006
|
|
|
|
|
usage-count-last-180-days: '0'
|
|
|
|
|
usage-count-since-2013: '8'
|
|
|
|
|
volume: '20'
|
|
|
|
|
web-of-science-categories: Public, Environmental \& Occupational Health
|
|
|
|
|
year: '2020'
|
