¿<i>Te Recurseas</i>? Mapping, Enumerating, and Describing Male and Transwomen Sex Workers in Venue-Based and Virtual Spaces in Lima, Peru

Bayer, Angela M.; Mallma, Patricia; Cárcamo, César; Díaz, David; Chirre, Miguel; Sánchez, Hugo; García, Patricia J.; Gorbach, Pamina M.

doi:10.1521/aeap.2019.31.6.567

Cited by 5 publications

(3 citation statements)

References 33 publications

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“…Older transgender women may have had less exposure or access to preventive testing, free anti-retroviral treatment, and informational and anti-stigma campaigns, which have become more common over time. In addition, though nearly half of respondents engage in sex work, putting them at increased risks for HIV, HIV-associated TB, and other STIs, 15 increasing age was associated with a decline in sex work. Older women may have a reduced HIV risk or perception of risk, leading them to test less frequently.…”

Section: Discussionmentioning

confidence: 99%

“…9 Transgender women are often forced to leave home after experiencing physical, sexual, and/or verbal violence and family rejection, 10 11 with many migrating to cities where they have few resources and support networks. 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%

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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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…In the aftermath of iPrEx and numerous PrEP implementation challenges that followed, emerging research among Peruvian MSM and trans women has highlighted the existence of mistrust of international drug trials, foreign investigators and Peruvian institutional actors implementing the studies as obstacles to widespread PrEP acceptance and use [22]. Notably, PrEP was approved by the Peruvian FDA in 2017 and yet, there is no current integration within Peru's public health system and availability for trans women occurs primarily in the context of HIV biomedical prevention research [23,24]. In this paper, we used qualitative methodology to explore the mistrust and its impact on research participation as reported by trans women who participated in a PrEP adherence trial and those who refused involvement in the study (i.e.…”

Section: Introductionmentioning

confidence: 99%

The wisdom of mistrust: qualitative insights from transgender women who participated in PrEP research in Lima, Peru

Perez-Brumer

Naz-McLean

Huerta³

et al. 2021

J Int AIDS Soc.

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Introduction: Although pre-exposure prophylaxis (PrEP) is a remarkable biomedical advance to prevent HIV, ongoing research on PrEP contributes to and interacts with a legacy of HIV experimentation on marginalized communities in resource-limited settings. This paper explores the complexity of PrEP research mistrust among Peruvian transgender (trans) women who completed a PrEP adherence intervention and those who refused participation (i.e. declined to enrol, voluntarily withdrew, and/or were lost to follow-up). Methods: Data were derived from 86 trans women (mean age 29 years) participants in the formative (four focus groups (n = 32), 20 interviews) and the evaluation stages (34 interviews) of a social network-based PrEP intervention for trans women in Lima, Peru. The formative stage took place from May to July 2015, while the evaluative stage took place from April to May 2018. Audio files were transcribed verbatim and analysed via an immersion crystallization approach using Dedoose (v.6.1.18). Results: Three paradoxes of trans women's participation in PrEP science as a "key" population emerged as amplifying mistrust:(1) increases in PrEP research targeting trans women but limited perceived improvements in HIV outcomes; (2) routine dismissal by research physicians and staff of PrEP-related side effects and the social realities of taking PrEP, resulting in questions about who PrEP research is really for and (3) persistent limitations on PrEP access for trans women despite increasing involvement in clinical trials, fostering feelings of being a "guinea pig" to advance PrEP science. Conclusions: Findings highlight the wisdom inherent in PrEP mistrust as a reflection of trans women's experiences that underscore the broken bonds of trust between communities, researchers and the research enterprise. PrEP mistrust is amplified through perceived paradoxes that suggest to trans women that they are key experimental participants but not target PrEP users outside of research settings. Findings highlight the urgent need to reframe mistrust not as a characteristic of trans women to be addressed through education and outreach, but as a systemic institutional-and industry-level problem replicated, manifested and ultimately to be corrected, through global HIV science.

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Decision-Making at the Intersection of Risk and Pleasure: A Qualitative Inquiry with Trans Women Engaged in Sex Work in Lima, Peru

et al. 2021

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¿Te Recurseas? Mapping, Enumerating, and Describing Male and Transwomen Sex Workers in Venue-Based and Virtual Spaces in Lima, Peru

Cited by 5 publications

References 33 publications

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

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

The wisdom of mistrust: qualitative insights from transgender women who participated in PrEP research in Lima, Peru

Decision-Making at the Intersection of Risk and Pleasure: A Qualitative Inquiry with Trans Women Engaged in Sex Work in Lima, Peru

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