Brief Report: Young Age and Sex Work Are Associated With HIV Seroconversion Among Transgender Women in São Paulo, Brazil

Veras, Maria Amélia de Sousa Mascena; Saggese, Gustavo Santa Roza; Gómez, José Luis Valdespino; Silveira, Paula Squarzoni da; Paiatto, Beatriz Nobre Monteiro; Ferreira, Denis Gonçalves; Souza, Paola Alves de; Calado, Rodrigo T.; Castejon, Márcia Jorge; Yamashiro, Rosemeire; Brígido, Luis Fernando de Macedo; Turner, Caitlin; Lin, Jess; Wilson, Erin C.; McFarland, Willi

doi:10.1097/qai.0000000000002737

Cited by 18 publications

(8 citation statements)

References 17 publications

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“…In a study carried out in Rio de Janeiro, with about 322 trans women, aged between 25 and 39 years, it was identified that 54%, equivalent to 174 women, were infected with HIV, about 62% were low-income and had intense sex work, which in part explains the occurrence of 46.3% and 54% of sexual and physical violence, respectively. [15] Veras and collaborators [2021] [16] cite prostitution as one of the main causes of seroconversion in trans women, especially between the ages of 18 and 24 years. The social vulnerability of sex professionals also provides situations that lead to sex without a condom, such as rape, extra payment for unprotected sex or the feeling of security and trust with stable partners, [17] as well as the frequent practice of anal sex, which is also a high risk factor for HIV transmission.…”

Section: Resultsmentioning

confidence: 99%

Prevalence And Particularities Associated With Positive Serology For HIV In Trans Women And Travestis Sex Professionals

2022

IRJPH

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Objective: This study aims to analyze the prevalence of HIV positive serology in trans women sex workers, and the main problems associated. Methods: Scientific articles were found searching data platforms (PubMed, Virtual Health Library, Web of Science and Google Scholar) as much as much as epidemiological bulletins and statistical data from the Ministério da Saúde do Brasil (Ministry of Health) and UNAIDS were included. Results: Gender violence and gender inequality can contribute to the increased vulnerability of the transgender population to HIV. Globally, trans women are 50 times more likely to be infected with HIV, with seroprevalence in Brazil ranging from 16.9% to 65.3%. Studies point to prostitution as one of the main causes of seroconversion in trans women, especially between the ages of 18 and 24 years. Due to the immense marginalization, transsexual women have an evident difficulty in entering the labor market and accessing basic rights, such as health. These factors contribute to a greater vulnerability to HIV infection. Conclusion: The Ministry of Health needs to improve more incisively the prevention and assessment strategies of the risk levels of HIV transmission, without perpetuating gender violence, including by making it invisible, which contributes to maintaining the vulnerability of the professional transsexual population of sex.

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Section: Resultsmentioning

confidence: 99%

Prevalence And Particularities Associated With Positive Serology For HIV In Trans Women And Travestis Sex Professionals

2022

IRJPH

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“…Several alternatives improve access to treatment among the HIV-positive population in Latin America, including Peru [16][17][18]. Cessation of treatment of newly diagnosed PLWHA in Peru is still high, especially considering the transgender population and MSM, who represent about 70% of newly diagnosed cases [19].…”

Section: Discussionmentioning

confidence: 99%

Linkage to care to reduce the gap in HIV treatment of people living with HIV/AIDS in Peru: 2016-2019 experience

Navarro¹,

Guevara²,

Caballero³

et al. 2023

HIV & AIDS Review

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Introduction: Time from identification as people living with HIV/AIDS (PLWHA) to a confirmatory test followed by antiretroviral therapy (ART) initiation is critical to any HIV prevention and control program. Gaps persist in identifying and linking PLWHA with health system, making it necessary to continue looking for strategies to close this breach.Material and methods: AIDS Healthcare Foundation (AHF) has been working on linking recently diagnosed HIV patients in Peru, and this paper summarized the experiences and results obtained from our linkage to care program between 2016 and 2019. Methods utilized for linkage to care include telephone communication, accompaniment to health service, social support, multidisciplinary team assessment, and initiation of ART when indicated. Results:During 2014-2019 we identified 9,991 PLWHA, in which 8,491 (84.98%) had an initial contact (initial linkage to care), and 6,899 (69.05%) received highly active antiretroviral therapy (effective link to care). We observed a consecutive increase in attention, as in the number of effective linkages, growing from 566 (80.17%) in 2016 to 3,237 (85.39%) in 2019. Among genders, males had the higher ratios of effective linkage to care (85.69%), while transgender women had the lower (79.14%). Conclusions:We observed that linkage to care is a strategy that provides more opportunities for treatment of PLWHA, and it is helpful in low-income countries.

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“…Under half of participants were able to attend four in-person sessions or more and maintain monthly communication for 4 months. Such findings are not new; studies have consistently found that the many structural inequities and challenges faced by transgender women, such as shortages of housing, money for transportation, or food or other basic needs, make it difficult to attend program and research visits [ 20 , 58 ]. Adherence to the navigation program was particularly low among younger participants and among those without stable housing, suggesting multiple vulnerabilities.…”

Section: Discussionmentioning

confidence: 99%

“…From May to November 2018, TWH age 18 and over were recruited from the CRT testing and treatment center, through community-based outreach, and from among participants testing HIV-positive in the Transnational cohort [ 36 ]. The Transnational Cohort Study was a longitudinal cohort of transgender women recruited through respondent-driven sampling (RDS); 545 participants were followed for just over 2 years, including biannual surveys and HIV testing in order to establish incidence [ 37 ]. Participants testing positive or sero-converting in the Transnational study were referred to TransAmigas.…”

Section: Methodsmentioning

confidence: 99%

Peer Navigation to Support Transgender Women’s Engagement in HIV Care: Findings from the Trans Amigas Pilot Trial in São Paulo, Brazil

et al. 2022

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Trans women living with HIV (TWH) have suboptimal HIV care engagement. We pilot tested Trans Amigas, a theory-based, trans-specific peer navigation (PN) intervention to address barriers to care in São Paulo, Brazil. TWH were randomized to the PN intervention (n = 75) or control (n = 38) condition. Control participants were referred to trans-friendly HIV care. Intervention participants were assigned a navigator who conducted nine in-person one-on-one sessions and bi-weekly phone or text check-ins to help participants overcome barriers to care and work towards gender affirmation and healthcare goals. We followed participants for 9 months to determine intervention feasibility, acceptability, and preliminary efficacy in improving retention in care. Analyses were intention to treat (ITT). Intervention acceptability was high: at end line, 85.2% of PN participants said they would continue receiving services and 94.4% would recommend peer navigation to a friend. A priori feasibility criteria were met: 92% of eligible participants enrolled and 70% were retained at 9 months; however, only 47% achieved moderate or better adherence to both in-person and phone/text program components. Though the pilot was not powered for efficacy, ITT findings trended toward significance, with intervention participants 40% more likely to be retained in care at the end of the study. Population-specific peer programming to support care engagement is acceptable, feasible, and can improve HIV outcomes for Trans women living with HIV.

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Brief Report: Young Age and Sex Work Are Associated With HIV Seroconversion Among Transgender Women in São Paulo, Brazil

Abstract: Background: Transgender women worldwide have the highest prevalence of HIV and the lowest access to prevention among groups at risk of HIV. However, few longitudinal studies have directly measured HIV incidence and identified predictors of HIV acquisition among transgender women.

Cited by 18 publications

References 17 publications

Prevalence And Particularities Associated With Positive Serology For HIV In Trans Women And Travestis Sex Professionals

Prevalence And Particularities Associated With Positive Serology For HIV In Trans Women And Travestis Sex Professionals

Linkage to care to reduce the gap in HIV treatment of people living with HIV/AIDS in Peru: 2016-2019 experience

Peer Navigation to Support Transgender Women’s Engagement in HIV Care: Findings from the Trans Amigas Pilot Trial in São Paulo, Brazil

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