Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative

Hirshfield, Sabina; Contreras, Judith; Luebe, R. Q.; Swartz, James A.; Scheinmann, Roberta; Reback, Cathy J.; Fletcher, Jesse B.; Kisler, Kimberly A.; Kuhns, Lisa M.; Molano, Luis Freddy

doi:10.1007/s10461-019-02667-6

Cited by 24 publications

(31 citation statements)

References 35 publications

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“…Social groups were frequently noted as protective, such as peer health support and community engagement (e.g., Hirshfield et al, 2019; Reback et al, 2019). Strong social networks and disclosure of HIV status (Chen et al, 2020) were also associated with healthcare utilisation, specifically within the realm of HIV care or prevention (e.g., PrEP uptake).…”

Section: Discussionmentioning

confidence: 99%

The health and wellbeing of transgender and gender non‐conforming people of colour in the United States: A systematic literature search and review

Farvid

Vance

Klein

et al. 2021

Community & Applied Soc Psy

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Transgender and gender non‐conforming people (TGNC), individuals whose gender identity differs from the sex they were assigned at birth, experience unique stressors, discrimination, and barriers to health and wellbeing. TGNC People of Colour (POC) navigate the nexus of racism, cisgenderism (and often homophobia) in their daily lives, resulting in uniquely intersecting forms of discrimination, and pronounced disparities in their health and well‐being. In order to examine the current state of knowledge about the health and wellbeing of TGNC POC, we conducted a systematic search and review of peer‐reviewed journal articles published between 1 January 2010 and 1 May 2020 that focused on this population. A systematic search identified (3,575) papers, with 76 of those meeting full inclusion criteria. In our review, we were able to identify physical health and psychological wellbeing (which included resilience), as core clusters of research focused on TGNC POC. We identified specific factors that hindered physical and psychological health (what we call “push” factors) as well as those that promoted it (what we call “pull” factors). Leveraging these findings, we offer ways forward for best practice in clinical work and carrying out research with this population. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

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Section: Discussionmentioning

confidence: 99%

The health and wellbeing of transgender and gender non‐conforming people of colour in the United States: A systematic literature search and review

Farvid

Vance

Klein

et al. 2021

Community & Applied Soc Psy

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“…Culturally responsive intervention efforts, in addition to gender affirming services and caring relationships with interventionists (31), may be most effective for improving care engagement and health outcomes among TWH at the individual level (32). Recent evidence from Los Angeles and San Francisco indicate that among transgender women of color living with HIV, the implementation of peer-delivered interventions positively impacts HIV care visit attendance, receipt of ART prescriptions, and retention in HIV care (33)(34)(35)(36).…”

Section: Background and Rationalementioning

confidence: 99%

An Intervention by and for Transgender Women Living With HIV: Study Protocol for a Two-Arm Randomized Controlled Trial Testing the Efficacy of “Healthy Divas” to Improve HIV Care Outcomes

Sevelius

Neilands

Reback

et al. 2021

Front. Reprod. Health

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Introduction: Transgender women (assigned “male” at birth but who do not identify as male) are disproportionately impacted by HIV and experience unique barriers and facilitators to HIV care engagement. In formative work, we identified culturally specific and modifiable barriers to HIV treatment engagement among transgender women living with HIV (TWH), including prioritizing transition-related healthcare over HIV treatment, avoiding HIV care settings due to gender-related and HIV stigma, concerns about potential drug interactions with hormones, and inadequate social support. Grounded in the investigators' Models of Gender Affirmation and Health Care Empowerment, we developed the Healthy Divas intervention to optimize engagement in HIV care among TWH at risk for treatment failure and consequential morbidity, mortality, and onward transmission of HIV.Methods and Analysis: We conducted a 2-arm randomized controlled trial (RCT) of the intervention's efficacy in Los Angeles and San Francisco to improve engagement in care among TWH (N = 278). The primary outcome was virologic control indicated by undetectable HIV-1 level (undetectability = < 20 copies/mL), at baseline and follow-up assessment for 12 months at 3-month intervals.Ethics and Dissemination: This study was approved by University of California, San Francisco Institutional Review Board (15-17910) and Western Institutional Review Board (20181370). Participants provided informed consent before enrolment in the study. We are committed to collaboration with National Institutes of Health officials, other researchers, and health and social services communities for rapid dissemination of data and sharing of materials. The results will be published in peer-reviewed academic journals and scientific presentations. We will make our results available to researchers interested in transgender health to avoid unintentional duplication of research, as well as to others in health and social services communities, including HIV clinics, LGBT community-based organizations, and AIDS service organizations.Clinical Trial Registration:Clinicaltrials.gov, identifier NCT03081559.

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“…Nonetheless, this work remains unique in TGD health‐focused research as it includes samples of TGD people living outside of North America and Europe. The urgency of this issue is apparent; estimates of between 15 and 19% of transgender women worldwide are living with HIV (Baral et al, 2013; Becasen, Denard, Mullins, Higa, & Sipe, 2019; WHO, 2015) with transgender women of color disproportionally burdened (Hirshfield et al, 2019). Data for transgender men is limited but estimates range from 0 to 10% (Becasen et al, 2019; Reisner & Murchison, 2016; WHO, 2015) compared to 0.8% for all individuals ages 15‐49, globally (WHO, 2018).…”

Section: Integrating Micbs Into Target Areas In Gender/sex Researchmentioning

confidence: 99%

Biocultural approaches to transgender and gender diverse experience and health: Integrating biomarkers and advancing gender/sex research

DuBois

Gibb

Juster

et al. 2020

American J Hum Biol

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Transgender and gender diverse (TGD) people are increasingly visible in U.S. communities and in national media. With this increased visibility, access to gender affirming healthcare is also on the rise, particularly for urban youth. Political backlash and entrenchment in a gender binary, however, continue to marginalize TGD people, increasing risk for health disparities. The 2016 National Institute of Health recognition of sexual and gender minority people as a health disparities population increases available funding for much-needed research. In this article, we speak to the need for a biocultural human biology of gender/sex diversity by delineating factors that influence physiological functioning, mental health, and physical health of TGD people. We propose that many of these factors can best be investigated with minimally invasively collected biomarker samples (MICBS) and discuss how to integrate MICBS into research inclusive of TGD people. Research use of MICBS among TGD people remains limited, and wider use could enable essential biological and health data to be collected from a population often excluded from research. We provide a broad overview of terminology and current literature, point to key research questions, and address potential challenges researchers might face when aiming to integrate MCIBS in research inclusive of transgender and gender diverse people. We argue that, when used effectively, MICBS can enhance human biologists' ability to empirically measure physiology and health-related outcomes and enable more accurate identification of pathways linking human experience, embodiment, and health.

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Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative

Cited by 24 publications

References 35 publications

The health and wellbeing of transgender and gender non‐conforming people of colour in the United States: A systematic literature search and review

The health and wellbeing of transgender and gender non‐conforming people of colour in the United States: A systematic literature search and review

An Intervention by and for Transgender Women Living With HIV: Study Protocol for a Two-Arm Randomized Controlled Trial Testing the Efficacy of “Healthy Divas” to Improve HIV Care Outcomes

Biocultural approaches to transgender and gender diverse experience and health: Integrating biomarkers and advancing gender/sex research

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