Globally, transgender women experience wide-ranging barriers to health and care, with disproportionately high risks of infectious and chronic diseases, mental illness, violence, and substance abuse. Despite these vulnerabilities, research on transgender populations in low- and middle-income countries is extremely limited. Furthermore, existing studies have primarily focused on HIV/AIDS, with less emphasis on transgender women's broader health needs. This cross-sectional study conducted in Lima, Peru aimed to analyze patterns of morbidity and health service uptake to identify subgroups that be especially in need of health interventions to improve access. We identified suboptimal levels of health coverage and access to care, with less education and older age as important risk factors for self-reported illness and HIV and tuberculosis (TB) testing, and differential HIV testing and pre-exposure prophylaxis (PrEP) usage among gender identity subgroups within Peru's broader community of transgender women. Both awareness of and interest in PrEP were suboptimal, and usage was low among those who were interested in taking PrEP. Future public health efforts should be tailored to the diverse needs of transgender women, bridge the gap between PrEP interest and use, and increase insurance coverage and access to trans-friendly services to promote improved health outcomes and equity.
It’s a muggy August evening and a thundershower is forming over the hilly treescape that frames Guatemala City’s urban center. I am rushing home from the supermarket, hoping to beat the storm. I’ve lived in Guatemala since 2018, though, recently, going to the supermarket is the only time I leave my apartment, as COVID-19 cases rise across the country. Driving through the city, neon-lit signs flicker on for restaurants and cafes that had, at one point, been under nationally mandated closure. At a stop light, I get a clear view into a well-known restaurant that had been one of my favorites, pre-COVID. Several clusters of people are seated inside a closed indoor space. None of them are wearing masks- a dramatic shift in the panorama from just months ago.
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