The purpose of this exploratory study was to examine the effects of legal name change on socioeconomic factors, general and transgender-related healthcare access and utilization, and transgender-related victimization in a sample of young transgender women (transwomen) of color. A cross-sectional group comparison approach was used to assess the potential effects of legal name change. A convenience sample of young transwomen enrolled in a no-cost legal name change clinic were recruited to complete a 30-minute interviewer-guided telephone survey including sociodemographic and socioeconomic factors, health and well-being, health care utilization, transgender transition-related health care, and transgender-related victimization. Sixty-five transgender women of color (37 = pre-name change group; 28 = post-name change group) completed the survey. Results indicated that the transwomen in the post-name change group were significantly older than the pre-name change group. In age-adjusted analyses, the post-name change group was significantly more likely to have a higher monthly income and stable housing than the pre-name change group. No significant differences were observed for general healthcare utilization; however, a significantly greater percentage of transwomen in the pre-name change group reported postponing medical care due to their gender identity. In addition, a significantly larger proportion of transwomen in the pre-name change group reported using non-prescribed hormones injected by friends and experiencing verbal harassment by family and friends compared to transwomen in the post-name change group. Findings suggest that legal name change may be an important structural intervention for low-income transwomen of color, providing increased socioeconomic stability and improved access to primary and transition-related health care.
Expectations to share data underlying studies are increasing, but research on how participants, particularly those in qualitative research, respond to requests for data sharing is limited. We studied research participants’ willingness to, understanding of, and motivations for data sharing. As part of a larger qualitative study on abortion reporting, we conducted interviews with 64 cisgender women in two states in early 2020 and asked for consent to share de-identified data. At the end of interviews, we asked participants to reflect on their motivations for agreeing or declining to share their data. The vast majority of respondents consented to data sharing and reported that helping others was a primary motivation for agreeing to share their data. However, a substantial number of participants showed a limited understanding of the concept of “data sharing.” Additional research is needed on how to improve participants’ understanding of data sharing and thus ensure fully informed consent.
In this report, we analyze the 2021 data, focusing on how respondents feel the COVID-19 pandemic has influenced their sexual and reproductive health in two core areas: fertility preferences and access to care, including use of telehealth. We note disparities according to individuals’ race and ethnicity, sexual orientation, gender identity, income level and economic well-being. To assess the ongoing scope and magnitude of the impacts of the pandemic, we also examine findings on comparable measures from the 2020 and 2021 GSRHE studies. These data provide four key findings: The pandemic has continued to shift fertility preferences and impede access to sexual and reproductive health care, including contraceptive services. The impacts reported in the summer of 2021 are smaller than those reported earlier in the pandemic but remain pervasive. The pandemic continues to have disproportionate effects on the sexual and reproductive health of those already experiencing systemic social and health inequities. Telehealth services are bridging gaps in sexual and reproductive health care resulting from pandemic-related upheaval, particularly for those who already experience barriers to accessing health care.
LGBTQ people of color and low-socioeconomic status face a heavy burden of health, economic, and social disparities. Understanding the factors that hinder or facilitate efforts to address these disparities is critical to achieving equity and improving social welfare. This study explores one potential factor: the spatial distribution of LGBTQ human services. A spatially referenced dataset of 193 LGBTQ human service sites in the Chicago area was compiled between November 2015 and January 2016. Sites were geocoded and mapped in ArcGIS along with data from the 2011-2015 American Community Survey. Geospatial techniques were used to assess racial and socioeconomic patterns in service distribution. Analyses revealed that sites were disproportionately located in majority non-Hispanic/Latino White (71.0%) and upper-income (63.7%) block groups. Additionally, analyses revealed that Black/African American, Hispanic/Latino, and poor to low-income residents of Chicago disproportionately live in LGBTQ service deserts. These patterns in the distribution of LGBTQ services may present barriers to addressing disparities by making services less accessible for racial/ethnic minorities and lower-income individuals. System-and structural-level interventions are needed to reduce spatial inequities in the distribution of LGBTQ human services in Chicago in order to facilitate efforts to address LGBTQ disparities among racial/ethnic minorities and individuals with lower socioeconomic status.
Background Young cisgender men who have sex with men (YMSM), young transgender women (YTW), and gender nonconforming (GNC) youth of color face substantial economic and health disparities. In particular, HIV risk and infection among these groups remains a significant public health issue. In 2017, 17% of all new HIV diagnoses were attributed to male-to-male sexual contact among adolescents and young adults aged 13 to 24 years. However, such disparities cannot be attributed to individual-level factors alone but rather are situated within larger social and structural contexts that marginalize and predispose YMSM, YTW, and GNC youth of color to increased HIV exposure. Addressing social and structural risk factors requires intervention on distal drivers of HIV risk, including employment and economic stability. The Work2Prevent (W2P) study aims to target economic stability through job readiness and employment as a structural-level intervention for preventing adolescent and young adult HIV among black and Latinx YMSM, YTW, and GNC youth. This study seeks to assess intervention feasibility and acceptability in the target populations and determine preliminary efficacy of the intervention to increase employment and reduce sexual risk behaviors. Objective The goal of the research is to pilot-test a tailored, theoretically informed employment intervention program among YMSM, YTW, and GNC youth of color. This intervention was adapted from Increased Individual Income and Independence, an existing evidence-based employment program for HIV-positive adults during phase 1 of the W2P study. Methods The employment intervention will be pilot-tested among vulnerable YMSM, YTW, and GNC youth of color in a single-arm pre-post trial to assess feasibility, acceptability, and preliminary estimates of efficacy. Results Research activities began in March 2018 and were completed in November 2019. Overall, 5 participants were enrolled in the pretest and 51 participants were enrolled in the pilot. Conclusions Interventions that address the social and structural drivers of HIV exposure and infection are sorely needed in order to successfully bend the curve in the adolescent and young adult HIV epidemic. Employment as prevention has the potential to be a scalable intervention that can be deployed among this group. Trial Registration ClinicalTrials.gov NCT03313310; https://clinicaltrials.gov/ct2/show/NCT03313310 International Registered Report Identifier (IRRID) DERR1-10.2196/16401
Abortion is a difficult-to-measure behaviour with extensive underreporting in surveys, which compromises the ability to study and monitor it. We aimed to improve understanding of how women interpret and respond to survey items asking if they have had an abortion. We developed new questions hypothesised to improve abortion reporting, using approaches that aim to clarify which experiences to report; reduce the stigma and sensitivity of abortion; reduce the sense of intrusiveness of asking about abortion; and increase respondent motivation to report. We conducted cognitive interviews with cisgender women aged 18–49 in two US states ( N = 64) to assess these new approaches and questions for improving abortion reporting. Our findings suggest that including abortion as part of a list of other sexual and reproductive health services, asking a yes/no question about lifetime experience of abortion instead of asking about number of abortions, and developing an improved introduction to abortion questions may help to elicit more accurate survey reports. Opportunities exist to improve survey measurement of abortion. Reducing the underreporting of abortion in surveys has the potential to improve sexual and reproductive health research that relies on pregnancy histories.
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