‘I'm not interested in research; i'm interested in services': How to better health and social services for transgender women living with and affected by HIV

Everhart, Avery; Boska, Hayden; Sinai‐Glazer, Hagit; Wilson-Yang, Jia Qing; Burke, Nora Butler; Leblanc, Gabrielle; Persad, Yasmeen; Ortigoza, Evana; Scheim, Ayden I.; Marshall, Zack

doi:10.1016/j.socscimed.2021.114610

Cited by 14 publications

(6 citation statements)

References 40 publications

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“…Our findings underscore the need for better integration of gender-affirming care with primary care, and vice versa, to optimize hormone adherence. Given differences between trans-friendly and trans-specific modes of service design and provision (Everhart et al, 2022), perspectives from trans patients regarding the ideal integration models, such as providing gender-affirming care in primary care settings vs. having primary care services in gender-affirming specialty clinics, could be helpful in understanding which models would feel more trustworthy, affirming, and likely to improve hormone adherence.…”

Section: Discussionmentioning

confidence: 99%

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Restar

Dusic

Garrison-Desany

et al. 2022

Humanit Soc Sci Commun

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Gender-affirming hormones have been shown to improve psychological functioning and quality of life among transgender and nonbinary (trans) people, yet, scant research exists regarding whether and why individuals take more or less hormones than prescribed. Drawing on survey data from 379 trans people who were prescribed hormones, we utilized multivariable logistic regression models to identify factors associated with hormone-dosing behaviors and content analysis to examine the reasons for dose modifications. Overall, 24% of trans individuals took more hormones than prescribed and 57% took less. Taking more hormones than prescribed was significantly associated with having the same provider for primary and gender-affirming care and gender-based discrimination. Income and insurance coverage barriers were significantly associated with taking less hormones than prescribed. Differences by gender identity were also observed. Addressing barriers to hormone access and cost could help to ensure safe hormone-dosing behaviors and the achievement trans people’s gender-affirmation goals.

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Section: Discussionmentioning

confidence: 99%

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Restar

Dusic

Garrison-Desany

et al. 2022

Humanit Soc Sci Commun

Self Cite

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“…Aligned with these recent calls for greater nuance, several recent studies have sought to go beyond merely highlighting the presence of stigma in spaces but interrogate how spatial elements socially produce or mitigate stigma. An example was a study interrogating how social spaces can facilitate PrEP knowledge and access [32 ▪▪ ], as well as health services research involving interviews with patients and providers that nuance how healthcare delivery mechanisms and structures create barriers to care [33,34].…”

Section: Multilevel Impact Of Stigma In the Context Of Hiv Health Ser...mentioning

confidence: 99%

Public health services and intersectional stigma: a social sciences perspective with implications for HIV service design and delivery

Tan

Tang

Tucker

2022

Current Opinion in HIV and AIDS

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Purpose of reviewUnderstanding stigma is important for improving HIV care services and gaps in HIV service delivery have been attributed to stigma. This review article synthesizes recent evidence on stigma and its implications for HIV service design and delivery. Given the intersectional nature of stigma, we will focus on HIV stigma as well as related forms of stigma based on one's race, sexual identity, gender identity and other identities.Recent findingsStigma remains a barrier to achieving equity in HIV services. Individualistic measures of stigma remain influential and are associated with barriers to accessing HIV health services. Recent work also highlights stigma measured at a structural level and its impact on HIV services contexts. Individuals situated at intersections of marginalized identities continue to face greatest injustices, and although intersectional approaches have been adapted to design services at a micro level, few focus on structural change. Recent evidence for mitigating stigma indicates some success for psychosocial interventions that target internalized stigma. Furthermore, community-led approaches show promise in addressing stigma that manifests in HIV health services settings.SummaryInterventions that address individual-level stigma and structural stigma are needed. Theoretical and applied antistigma research is needed to make HIV services more equitable.

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“…Unlike other group discussion designs on trans issues, wherein healthcare workers and trans people are not in the same group, 29 , 46 – 49 in this study, trans speakers with different trans backgrounds and HIV screeners were jointly involved in the group discussions via a video chat room. This enabled the group members to interact directly by seeing and hearing one another.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of communication platforms to empower transgender cultural competence among human immunodeficiency virus screeners: A qualitative analysis

Chiou,

Chou,

Tsao

et al. 2023

DIGITAL HEALTH

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Background Human immunodeficiency virus (HIV) screeners have limited experience of interacting with trans people. The application of communication platforms between them to empower HIV screeners’ trans-related cultural competence remains unknown. Objective This study aims to qualitatively explore the follow-up interviews of HIV screeners regarding their opinions on the feasibility of an online platform group discussion and web page to enhance communication between them and trans people and to explore their perspectives on how these components enhanced their promotion of cultural competence. Methods This study was conducted between October 2020 and June 2021. Purposive and snowball sampling were applied to recruit 6 trans persons and 11 HIV screeners. Six online platform group discussions were held on weekday evenings, each group meeting for 60 min, 360 min in total within 3 months, via a video chat room of Google Meet; this was supplemented by a closed web page. The major results were presented through content analysis of the HIV screeners’ follow-up interviews. Results The HIV screeners identified the facilitators of participating in the communication platforms, which included a reminder message, easy-to-use interface, visible–audible and readable interaction, recalled and reviewable content and group belonging; the barriers included time and space limitation, device restrictions and operation problem. Two categories of trans-related cultural competence – trans awareness and action taken – were revealed, from which five major themes emerged: provoked to ask questions, improved cognition, reflection, trans-sensitive communication and self-enhancement. Conclusion The results revealed that the communication platforms could facilitate the mutual and vivid discussion between HIV screeners and trans people and empower the trans-related cultural competence of HIV screeners. The highly feasible intervention design of this research can be applied to digital training courses related to gender diversity issues.

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‘I'm not interested in research; i'm interested in services': How to better health and social services for transgender women living with and affected by HIV

Cited by 14 publications

References 40 publications

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Public health services and intersectional stigma: a social sciences perspective with implications for HIV service design and delivery

Feasibility of communication platforms to empower transgender cultural competence among human immunodeficiency virus screeners: A qualitative analysis

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