Engagement in Care and Housing Instability Influence HIV Screening Among Transgender Individuals in South Florida

Cyrus, Elena; Johnson, Shaina A.; Perez-Gilbe, Hector R.; Wuyke, Gabriella; Fajardo, Francisco; Garba, Nana Aisha; Dévieux, Jessy G.; Jimenez, Daniel; Garcia, Stéphanie; Holder, Cheryl

doi:10.1089/trgh.2020.0066

Cited by 4 publications

(5 citation statements)

References 39 publications

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“…Over two-thirds of the South Florida community identifies as Hispanic/Latine/Latinx, with many of these individuals also identifying as people of color and as foreign-born [ 20 ]. South Florida has also had one of the highest rates of HIV in the country since the beginning of the HIV epidemic; no reductions in HIV prevalence have been seen among communities of color in this region, including, but not limited to, transgender women of color who may also identify as Latina [ 21 , 22 ]. Moreover, the cost of living in South Florida is extremely high, which explains why the area has the third-highest rate of homelessness in the US [ 21 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…Purposive sampling and participant referrals were used to identify participants, given that they are a population that is systematically under-recruited for clinical research and may be difficult to access as a result [ 22 , 23 , 24 ]. The potential participants were informed about the study by peer educators and navigators at the participating organizations.…”

Section: Methodsmentioning

confidence: 99%

“…The potential participants were informed about the study by peer educators and navigators at the participating organizations. Additionally, the participants from a prior study conducted among transgender women at these organizations by the lead researcher were also contacted if permission had been documented [ 22 ]. The potential participants expressing interest were connected with project staff to assess eligibility and willingness to participate and to answer questions about the study.…”

Section: Methodsmentioning

confidence: 99%

“…During the third and final stage, transcripts were assigned to the research team members for coding. The transcriptions were coded according to the thematic categories that emerged from the data, i.e., the categories were developed, collected, and analyzed primarily from an inductive (with some deductive) thematic analysis perspective [ 22 ]. The codes described transgender women’s lived experiences and focused on the barriers and facilitators related to accessing HIV preventive care.…”

Section: Methodsmentioning

confidence: 99%

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Barriers to Accessing and Engaging in HIV Preventive Care and Pre-Exposure Prophylaxis Experienced by Transgender Women in Florida

Maragh-Bass,

Kiplagat,

Lavari

et al. 2024

IJERPH

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Background: PrEP, a biomedical HIV prevention option, continues to be underutilized among transgender women who could benefit from sustained use, especially women of color and those who identify as Latina and/or reside in the southeastern US. Objective: We explored the barriers and facilitators experienced by transgender women who live in Florida regarding accessing, using, and/or staying on PrEP. Methods: In-depth interviews and focus groups were conducted in either Spanish or English with adult transgender women living in Florida (N = 22). The interviews were audio-recorded, transcribed, and coded in ATLAS.ti using thematic analyses. Results: The mean age of the participants was 42.2 years. Among the participants, 73% were Hispanic/Latina, 59% were foreign-born, and approximately one-third were living with HIV (but had past experience with PrEP). Transgender women cited the following barriers to accessing or considering PrEP: (1) costs and benefits of PrEP use; (2) under-representation in clinical trials resulting in unknown or misinformation regarding PrEP side effects; (3) chronic poverty; and (4) trauma and discrimination. Other stressors, such as behavioral healthcare needs, were identified. Conclusions: Our analysis revealed interlocking systems of oppression like transphobia, discrimination, and misgendering, which were common barriers experienced by our participants. These synergistically epidemic (i.e., syndemic) barriers contributed to their feelings of being systematically excluded in social spaces, research, public health planning and policies, laws, and social programs related to PrEP. These structural barriers are impediments to HIV preventive care but also act as a source of stress that contributes to mental health problems, financial vulnerability, substance abuse, and other deleterious health outcomes.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Barriers to Accessing and Engaging in HIV Preventive Care and Pre-Exposure Prophylaxis Experienced by Transgender Women in Florida

Maragh-Bass,

Kiplagat,

Lavari

et al. 2024

IJERPH

Self Cite

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“…The Haitian focus group felt that annual medical physicals, including HIV/STI screening, should be promoted-especially among youth. Individuals who receive annual medical check-ups or are actively engaged in care are more likely to have routine HIV/STI screenings (Cyrus et al, 2021). One benefit of identifying HIV infection prior to symptomatic presentation is that early detection can aid in the prevention of acute infection by sexual partners, and routine screening also presents opportunities to discuss HIV prevention options (Buchacz et al, 2005).…”

Section: Increase Access To Existing Resourcesmentioning

confidence: 99%

Barriers and Perceived Facilitators for PrEP Use Among Women of Color in South Florida: Findings from theEmpowering Women to Take Control of Their Sexual Health Summit

Cyrus,

Villalba,

Jean-Gilles

et al. 2023

Preprint

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This paper aims to summarize conference proceedings and testimonies from the, Empowering Women to Take Control of Their Sexual Health Summit, convened in South Florida. In the present study, the phrase, women of color, refers to 279 cisgender and transgender African American, Latina, and Haitian women. Data were collected through three 90-minute group discussions conducted at the conference. Individual-, social-, and structural-level PrEP barriers and facilitators were identified. Individual level barriers included: medical distrust, limited knowledge about PrEP, and economic dependence on sexual partners. Participants discussed cultural gender norms and roles as overarching social barriers, with religiosity reinforcing these norms. Structural barriers included: health literacy, health insurance coverage, immigration status, and structural racism. Community attributes that acted as facilitators of PrEP use were resilience and adaptability. Increasing PrEP utilization among women of color requires a multi-tiered approach to comprehensively address structural and community level barriers. Keywords: women, HIV, prevention, barriers, facilitators

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Association of Neighborhood Deprivation With Healthcare Utilization Among Persons With Human Immunodeficiency Virus: A Latent Class Analysis

Montano-Campos

Stout

Pettit

et al. 2023

Open Forum Infectious Diseases

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Background We previously identified three latent classes of healthcare utilization among people with HIV (PWH): “adherent”, “non-adherent” and “sick”. Although membership in the “non-adherent” group was associated with subsequent disengagement from HIV care, socioeconomic predictors of class membership remain unexplored. Methods We validated our healthcare utilization-based latent class model of PWH receiving care at Duke University (Durham, North Carolina) using patient-level data from 2015- 2018. Social Deprivation Index (SDI) scores were assigned to cohort members based on residential addresses. Associations of patient-level covariates with class membership were estimated using multivariable logistic regression and movement between classes was estimated using latent transition analysis. Results 1443 unique patients (median age 50 years, 28% female sex at birth, 57% Black) were included in the analysis. PWH in the most disadvantaged (highest) SDI decile were more likely to be in the “non-adherent” class than the remainder of the cohort (odds ratio [OR] 1.58; 95% confidence interval [CI] 0.95-2.63) and were significantly more likely to be in the “sick” class (OR 2.65; 95% CI 2.13-3.30). PWH in the highest SDI decile were also more likely to transition into and less likely to transition out of the “sick” class. Conclusions PWH who resided in neighborhoods with high levels of social deprivation were more likely to have latent class membership in suboptimal healthcare utilization groupings, and membership persisted over time. Risk stratification models based on healthcare utilization may be useful tools in the early identification of persons at risk for suboptimal HIV care engagement.

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Engagement in Care and Housing Instability Influence HIV Screening Among Transgender Individuals in South Florida

Cited by 4 publications

References 39 publications

Barriers to Accessing and Engaging in HIV Preventive Care and Pre-Exposure Prophylaxis Experienced by Transgender Women in Florida

Barriers to Accessing and Engaging in HIV Preventive Care and Pre-Exposure Prophylaxis Experienced by Transgender Women in Florida

Barriers and Perceived Facilitators for PrEP Use Among Women of Color in South Florida: Findings from theEmpowering Women to Take Control of Their Sexual Health Summit

Association of Neighborhood Deprivation With Healthcare Utilization Among Persons With Human Immunodeficiency Virus: A Latent Class Analysis

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