Confluent paths: Research and community participation to protect the right to health among transgender women in Peru

Salazar, Ximena; Núnez-Curto, Arón; Aguilar, Jana Villayzán; Lusquiños, Miluska; Motta, Angélica; Cáceres, Carlos

doi:10.1080/17441692.2019.1599982

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…In addition, PrEP studies have shown low PrEP continuation among TGW [ 36 ]. Research has highlighted the need for PrEP programmes to specifically address the needs of trans populations, including TGW [ 31 , 37 , 38 , 39 ]. However, efforts towards this end have been limited [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with long‐term HIV pre‐exposure prophylaxis engagement and adherence among transgender women in Brazil, Mexico and Peru: results from the ImPrEP study

et al. 2022

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Introduction The HIV epidemic continues to disproportionately impact Latin‐American transgender women (TGW). We assessed factors associated with long‐term pre‐exposure prophylaxis (PrEP) engagement and adherence among TGW enrolled in the Implementation of PrEP (ImPrEP) study, the largest PrEP demonstration study in Latin America. Methods HIV‐negative TGW aged ≥18 years reporting 1+eligibility criteria in the 6 months prior to enrolment (e.g. sex partner known to be living with HIV, condomless anal sex [CAS], transactional sex or having a sexually transmitted infection [STI]) who could safely take PrEP were enrolled. Follow‐up visits were conducted at 4 weeks and then quarterly. We conducted logistic regression to identify factors associated with long‐term PrEP engagement (3+ follow‐up visits in 52 weeks) and complete self‐reported adherence (no missed pills in the past 30 days) during follow‐up. For both outcomes, we constructed multivariable models controlling for country, socio‐demographics, sexual behaviour, substance use, STIs and self‐reported adherence at 4 weeks (long‐term engagement outcome only). Results From March 2018 to June 2021, ImPrEP screened 519 TGW, enrolled 494 (Brazil: 190, Mexico: 66 and Peru: 238) and followed them for 52 weeks. At baseline, 27.5% of TGW were aged 18–24 years, 67.8% were mixed‐race and 31.6% had >secondary education. Most, 89.9% reported CAS, 61.9% had >10 sex partners and 71.9% reported transactional sex. HIV incidence was 1.82 cases per 100 person‐years (95% confidence interval [CI]: 0.76–4.38). Almost half of TGW (48.6%) had long‐term PrEP engagement, which was positively associated with reporting complete adherence at week 4 (aOR:2.94 [95%CI:1.88–4.63]) and was inversely associated with reporting CAS with unknown‐HIV partner (aOR:0.52 [95%CI:0.34–0.81]), migration (aOR:0.54 [95%CI:0.34–0.84]), and being from Mexico (aOR:0.28 [95%CI:0.14–0.53]). Self‐reported adherence was associated with TGW aged >34 (aOR:1.61 [95%CI:1.10–2.34]) compared to those aged 25–34 and those with >secondary education (aOR:1.55 [95%CI:1.10–2.19]) and was lower among TGW from Peru (aOR:0.29 [95%CI:0.21–0.41]) or reporting PrEP‐related adverse effects (aOR:0.63 [95%CI:0.42–0.92]). Conclusions Although TGW were willing to enrol in ImPrEP, long‐term PrEP engagement and complete self‐reported adherence were limited, and HIV incidence remained relatively high. A successful HIV prevention agenda should include trans‐specific interventions supporting oral PrEP and exploring long‐acting PrEP strategies for TGW.

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Section: Introductionmentioning

confidence: 99%

Factors associated with long‐term HIV pre‐exposure prophylaxis engagement and adherence among transgender women in Brazil, Mexico and Peru: results from the ImPrEP study

et al. 2022

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“…Sex workers in this context have fought for HIV policy and programming that explicitly acknowledges the link between HIV vulnerability and key structural factors including stigma, gender inequalities, and the criminalisation of sex work. In their contribution to the issue, Salazar et al (2019) argue that the HIV-research industry in Peru has provided a context in which emergent transgender women's activism has taken shape. But this contribution to the issue and that of Castellanos (2019), which analyses LGBT activism in the Dominican Republic taking place amidst international funding for HIV prevention, both foreground an important cautionary: social action agendas carried out under the heavy shadow of international aid and research dollars has, in some cases, succumbed to a narrower public-health focus rather than assiduously pursing demands for political recognition and broader social rights.…”

Section: Case Studies In Contemporary Social Action For Healthmentioning

confidence: 99%

Social inequities and contemporary struggles for collective health in Latin America

Vásquez

Perez-Brumer

Parker

2019

Global Public Health

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As part of a planned series from Global Public Health aimed at exploring both the epistemological and political differences in diverse public health approaches across different geographic and cultural regions, this special issue assembles papers that consider the legacy of the Latin American Social Medicine and Collective Health (LASM-CH) movements, as well as additional examples of contemporary social action for collective health from the region. In this introduction, we review the historical roots of LASM-CH and the movement's primary contributions to research, activism and policy-making over the latter-half of the twentieth century. We also introduce the special issue's contents. Spanning 19 papers, the articles in this special issue offer critical insight into efforts to create more equitable, participatory health regimes in the context of significant social and political change that many of the countries in the region have experienced in recent decades. We argue that as global health worldwide has been pushed to adopt increasingly conservative agendas, recognition of and attention to the legacies of Latin America's epistemological innovations and social movement action in the domain of public health are especially warranted.

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“…12 High prevalence of sex work, often one of the only livelihood options available, 13 14 is linked with risky behaviors 15 and increases risks for STIs and other infectious diseases. 16 13…”

Section: Introductionmentioning

confidence: 99%

“…9 For TGW who migrate to cities where they have limited support, 10 sex work is often one of the only livelihood options available, 11,12 increasing the risks for STIs, including HIV/AIDS, and other infectious diseases. 13 The health needs and healthcare utilization of TGW remain understudied. 4,14 Less than 0.01% of PubMed articles focus on transgender populations, with most articles from the US.…”

Section: Introductionmentioning

confidence: 99%

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A cross-sectional analysis of self-reported needs and health service utilization among transgender women in Lima, Peru

Carosella¹,

Huerta²,

Galea

et al. 2022

Preprint

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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.

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Confluent paths: Research and community participation to protect the right to health among transgender women in Peru

Cited by 5 publications

References 13 publications

Factors associated with long‐term HIV pre‐exposure prophylaxis engagement and adherence among transgender women in Brazil, Mexico and Peru: results from the ImPrEP study

Factors associated with long‐term HIV pre‐exposure prophylaxis engagement and adherence among transgender women in Brazil, Mexico and Peru: results from the ImPrEP study

Social inequities and contemporary struggles for collective health in Latin America

A cross-sectional analysis of self-reported needs and health service utilization among transgender women in Lima, Peru

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