Condomless Sex and Psychiatric Comorbidity in the Context of Constrained Survival Choices: A Longitudinal Study Among Homeless and Unstably Housed Women

Meacham, Meredith C.; Bahorik, Amber L.; Shumway, Martha; Marquez, Carina; Riley, Elise D.

doi:10.1007/s10461-018-2280-5

Cited by 8 publications

(3 citation statements)

References 72 publications

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“…A Brazilian study showed that transgender women was eight and five times more likely to test positive for HIV and syphilis, respectively, than cisgender women and men [ 19 ]. The STIs can contribute to higher morbidity and mortality in the homeless population due the lack of care and access to health services [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Sexual assault and vulnerability to sexually transmitted infections among homeless Brazilian women: a cross sectional qualitative study

Gonçalves Barbosa,

Carvalho Mendes,

da Costa Carbogim

et al. 2023

BMC Women's Health

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Background Homeless women have complex life conditions and are often exposed to violence, sexual exploitation, rape, prostitution, reproductive disorders, survival sex trading, unintended pregnancies and sexually transmitted infections (STIs). The aim was to explore the existence of sexual aggression and vulnerability to STIs among homeless Brazilian women. Methods Fifteen interviews were conducted with homeless women who were admitted to a women’s shelter in a large city in Brazil. Data were collected through semi-structured interviews, audiorecorded and complemented with notes of the researcher in field diary, subjected to inductive thematic analysis and analyzed in light of the social relations of gender. Results Two themes were constructed: “Being a woman on the streets: a look at gender inequalities” and “Pain and the raped body: the scars of homeless women”. The transgression of women’s rights was observed with reports of sexual abuse interspersed with physical violence. Unprotected sexual practices were part of the daily lives of these women, with repercussions for their exposure to sexually transmitted infections. Dependence on psychoactive substances was mentioned, and transactional sex was used as a source of income to maintain such dependence, as well as to promote the women’s livelihood. Conclusion Homeless women experience complex situations on the streets involving exposure to different types of violence, the use of transactional sex as a survival strategy and unprotected sexual practices. Furthermore, the way in which women have been exposed to sexual assault and their coping mechanisms to those require attention. Interventions are need to improve the healthcare assistance of homeless women victims of sexual assault, considering the vulnerability of this population.

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Section: Discussionmentioning

confidence: 99%

Sexual assault and vulnerability to sexually transmitted infections among homeless Brazilian women: a cross sectional qualitative study

Gonçalves Barbosa,

Carvalho Mendes,

da Costa Carbogim

et al. 2023

BMC Women's Health

View full text Add to dashboard Cite

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“…The day-to-day challenges of having to prioritize access to government assistance over employment, and the ways in which housing instability destabilized engagement in HIV care were deeply rooted and intersecting themes observed across WLHIVs' HIV treatment challenges. Regarding efforts to end the HIV epidemic, previous work has observed that unsheltered WLHIV are less likely to receive and engage with HIV care (11,36,40,41) while simultaneously experiencing other risk factors that could impede efforts to reduce HIV transmission, like illicit drug use (37,42,43), risky sexual behavior (44)(45)(46), and poor mental health (46)(47)(48).…”

Section: Discussionmentioning

confidence: 99%

Structural Barriers to Women’s Sustained Engagement in HIV Care in Southern California

et al. 2020

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Since the introduction of antiretroviral therapy, the number of women living with HIV (WLHIV) continues to increase. Despite the decrease in HIV diagnosis among women in California, less than half of WLHIV are retained in HIV care. Structural barriers put women at increased risk for delayed HIV diagnosis, delayed entry into HIV care, and poorer treatment outcomes. The objective of this qualitative analysis is to identify how structural barriers negatively impact women's sustained engagement in HIV care in Southern California. WLHIV accessing local HIV support services participated in a qualitative study by completing a semi-structured interview and brief survey between January and April 2015 (n=30). Poverty, unemployment, housing instability, and needs for transportation emerged as the dominant structural barriers for women when discussing their challenges with sustained engagement in HIV care. System-level interventions that decrease these noted barriers may help improve HIV care continuum for women living in Southern California.Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1

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“…In the U.S.-Mexico border region of San Diego, a focal point for "Ending the AIDS Epidemic," 2 and globally, HIV risk is higher among vulnerable cisgender women who experience violence, homelessness, and substance use. [3][4][5] In San Diego County, only 52% of cisgender women living with HIV (WLWH) were retained in HIV care and 62% were virally suppressed. 6 Latinos experienced as much as a 36% increase in HIV cases.…”

Section: Introductionmentioning

confidence: 99%

Effects of an HIV Peer Navigation Intervention for Women Living with HIV: A Brief Report

Urada

McClung

Brocklin

et al. 2022

MRAJ

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Background: Peer navigation is an evidence-based model for engaging and retaining women living with HIV in medical care. Participants of an adapted Lotus peer navigation group intervention were hypothesized to have more self-perceived HIV self-care and advocacy behaviors following their participation than non-Lotus participants at an agency serving cisgender women and their families affected by HIV in San Diego, California. Methods: The peer navigation intervention, Lotus, was adapted to include new modules on substance use, human trafficking, and intimate partner violence and piloted to compare its overall effects with a comparison group (2018-2019). Ninety-five cisgender women living with HIV (WLWH) completed posttest surveys measuring their perceived changes in peer advocacy and self-advocacy following their participation in a pilot of an adapted Lotus. Participants of the four-session Lotus group intervention (n=34) were compared to non-Lotus participants who engaged in other types of group activities at the agency (n=61). The Lotus group participants included a cohort of cisgender women > 50 years old, English and Spanish speaking women, and a mixed age and race/ethnicity group. All clients of Christie’s Place, an organization for women living with HIV in San Diego, were eligible if they were not actively using illicit substances substances in the past year. Cross-sectional bivariate analyses were run to determine differences between intervention and comparison groups. The groups were not randomized. Results: Among 95 participants, 17% were White, 14% Black/African American, 44% Hispanic/Latino, and 25% Other/Mixed race/ethnicity with median age 51 years (IQR: 45-60). Eleven Latina, 9 White, 6 Black/African American, and 8 Other/Mixed individuals participated in Lotus. In bivariate analyses, Lotus WLWH living with HIV at posttest took their HIV medications correctly (p=0.040) and attended their healthcare/other service appointments as advised/scheduled 3 times more often than non-Lotus WLWH (p=0.014). They advocated for themselves within medical and social service settings 6 times more often (p<0.001) and talked openly with their doctor 4 times more often (p=0.028). They were also twice as likely to talk more often with their partner about safer sex (p=0.022) and PrEP (p=0.037) and a peer about safer sex (p=0.001). They were 3 times more likely to help a peer understand how HIV medications can improve their health (p=0.001). Medical records showed all Lotus intervention participants as virally suppressed one year after their participation. Conclusions: Participants of an HIV peer navigation intervention experienced significant changes in self-reported self-advocacy outcomes. Peer navigation training interventions remain critical for medication adherence and self-advocacy among cisgender WLWH.

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Condomless Sex and Psychiatric Comorbidity in the Context of Constrained Survival Choices: A Longitudinal Study Among Homeless and Unstably Housed Women

Cited by 8 publications

References 72 publications

Sexual assault and vulnerability to sexually transmitted infections among homeless Brazilian women: a cross sectional qualitative study

Sexual assault and vulnerability to sexually transmitted infections among homeless Brazilian women: a cross sectional qualitative study

Structural Barriers to Women’s Sustained Engagement in HIV Care in Southern California

Effects of an HIV Peer Navigation Intervention for Women Living with HIV: A Brief Report

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