Contesting everyday violence: Resilience pathways of gay and transgender youth in Peru

Suarez, Eliana Barrios; Logie, Carmen H.; Arocha, José F.; Sanchez, Hugo Santiago; Shokirova, Takhmina

doi:10.1080/17441692.2020.1856397

Cited by 6 publications

(8 citation statements)

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“…This increased vulnerability is caused by substantial social marginalization and isolation experienced by TGW, leading to poverty, lower education and exclusion from the formal labour market [ 8 ], leading to high rates of sex work [ 6 , 9 , 10 , 11 ]. In Brazil, Mexico and Peru, TGW also experience substantial violence [ 11 , 12 , 13 , 14 ], internalized stigma and fear of discrimination [ 15 , 16 ] and increased burdens of mental health and substance abuse [ 17 ]. These vulnerabilities can also influence their health‐seeking behaviour and engagement in HIV prevention services.…”

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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“… 80 In Peru, people who identify with diverse gender identities experience various forms of violence, 81 82 which makes the process of accepting their own identity difficult. 82 We will increase awareness of gender diversity and inclusive practices among all members of the research team. A statement will be made that this project is an inclusive space, and group rules will be established by the participants at the beginning of the project.…”

Section: Methodology and Analysismentioning

confidence: 99%

An ounce of prevention is worth a pound of cure—the arts as a vehicle for knowledge translation and exchange (KTE) in public health during a pandemic: a realist-informed developmental evaluation research protocol

et al. 2022

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IntroductionThe COVID-19 crisis has led to the adoption of strict and coercive preventive measures. The implementation of these measures has generated negative impacts for many communities. The situation is especially worrisome for Indigenous communities in Peru. Therefore, it is necessary to recognise the contribution of the experiential knowledge of Indigenous communities and to implement innovative approaches. The use of art can be a promising avenue for working in partnership with Indigenous communities.The goal of this research is to (1) develop an intervention promoting barrier measures and vaccination to limit the transmission of COVID-19 among Indigenous communities using an arts-based and community-based knowledge translation and exchange (ACKTE) model; and (2) understand the contextual elements and mechanisms associated with the process of developing a preventive intervention using the ACKTE model.Methodology and analysisThis research will take place in Indigenous communities in Peru and will be based on a developmental evaluation guided by the principles of realist evaluation. Members of two Indigenous communities, local authorities, health professionals and artists will participate in the intervention development process as well as in the developmental evaluation. For data collection, we will conduct modified talking circles and semistructured individual interviews with stakeholders as well as an analysis of documents and artistic works produced.Ethics and dissemination of resultsThis research received the approval of the Université du Québec à Rimouski’s research ethics board. In addition to scientific articles, the results of this research will be disseminated through videos and during an artistic performance.

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“…This dynamic conceptualisation of agency as incremental, multi-level and non-linear has also been developed by others (Ahmed, 2010;Campbell & Mannell, 2016;Madhok, 2013) to amplify the processes of persisting, resisting and survival that may be overlooked in a traditional empowerment framing of action, influence, and control. Suarez et al (2020) further point to the interlocking nature of individual and collective resilience, emphasising that social processes of exclusion experienced by gay and trans youth in Peru inhibit self-acceptance while also sparking collective unity, resilience and, at times, activism. The same access to collective resilience was not available for gay asylum-seeking Senegalese men in Mauritania, whose ethnicity, immigration status, sexuality and HIV status produced social and economic exclusion both within Senegal and Mauritania.…”

Section: The Importance Of Agency and Community For Confronting Barriers To Sexual Rightsmentioning

confidence: 99%

“…Turning to assessing the lived experience of gay and transgender Peruvian youth, in 'Contesting everyday violence: Resilience pathways of gay and transgender youth in Peru', Suarez et al (2020) discuss the impacts of the legal exclusion of violence targeting lesbian, gay, bisexual, transgender and intersex persons in Peru from hate crime legislation. This creates a puzzling situation where LGBTQ+ persons have human rights protections in Peru's legal system yet are not protected specifically from LGBTQ+ directed violence.…”

Section: Legal Barriers To Realising Sexual Rightsmentioning

confidence: 99%

“…Other papers in this collection also take up the dimensionality of agency in enacting sexual rights. For example, Suarez et al (2020) discuss individual and collective resilience processes among young gay cisgender and trans persons in Peru. They framed self-esteem as produced by both self-acceptance and community acceptance, with different experiences between rural and urban participants, also suggesting the importance of contextual resources for realising selfworth.…”

Section: The Importance Of Agency and Community For Confronting Barriers To Sexual Rightsmentioning

confidence: 99%

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The contested global politics of pleasure and danger: Sexuality, gender, health and human rights

Logie

Perez-Brumer

Parker

2021

Global Public Health

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This special issue of Global Public Health brings together papers examining how sexuality, gender, health and human rights have become increasing visible and highly contested within global health. The papers included here question and explore the often contradictory processes through which global equity-seeking populations negotiate pleasure and danger across multiple arenas (including HIV and AIDS, LGBTQ+ health and rights, intersex rights, sex worker rights, realities of refugee and displaced persons, and gender-based violence) and in diverse geographic contexts

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Contesting everyday violence: Resilience pathways of gay and transgender youth in Peru

Cited by 6 publications

References 50 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

An ounce of prevention is worth a pound of cure—the arts as a vehicle for knowledge translation and exchange (KTE) in public health during a pandemic: a realist-informed developmental evaluation research protocol

The contested global politics of pleasure and danger: Sexuality, gender, health and human rights

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