“In the Bible Belt:” The role of religion in HIV care and prevention for transgender people in the United States South

Scott, Darius; Pereira, Nastacia M.; Harrison, Sayward E.; Zarwell, Meagan; Sanasi-Bhola, Kamla; Poteat, Tonia

doi:10.1016/j.healthplace.2021.102613

Cited by 8 publications

(8 citation statements)

References 55 publications

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“…18 Primary care clinics seeking to strengthen STI and HIV services must commit to providing care that supports and affirms individuals from sexual and gender minority groups who are seeking care. 30 In addition, because minoritized racial and ethnic groups experience a disproportionate burden of STIs and HIV, clinics should also be aware of the role that structural racism has played in shaping the HIV epidemic and how racism continues to result in subpar HIV services for Black individuals. 31s Rigorous work has previously identified, for instance, that Black MSM engage in similar or fewer risk behaviors than White MSM, yet have a far higher likelihood of acquiring HIV.…”

Section: Discussionmentioning

confidence: 99%

“…Populations that experience stigma may be reluctant to seek care as cultural and socioreligious norms around sexuality and gender in the southern US often create hostile environments for MSM and transgender individuals 18 . Primary care clinics seeking to strengthen STI and HIV services must commit to providing care that supports and affirms individuals from sexual and gender minority groups who are seeking care 30 …”

Section: Discussionmentioning

confidence: 99%

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Identifying the Need for and Availability of Evidence-Based Care for Sexually Transmitted Infections in Rural Primary Care Clinics

Merrell,

Crouch,

Harrison

et al. 2023

Sexual Trans Dis

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Background Increasing rates of bacterial sexually transmitted infections (STI) may lead to increased HIV rates, as the STI and HIV epidemics are syndemic. Centers for Disease Control and Prevention (CDC) guidelines recommend including extragenital (i.e., rectal and/or pharyngeal) STI screenings for certain populations at increased risk for STIs and concurrent infections with HIV. Methods A descriptive study was conducted by interviewing staff members from four rural primary care clinics in areas of high need for STI and HIV services in South Carolina. Qualitative data about their clinical practices in 2021 was obtained. The primary outcome was to determine the awareness and availability of health care services associated with STI and HIV care in these locations. Results Clinics in target counties provided limited STI and HIV testing and treatment services, especially for populations at risk of infection, indicating the need for additional clinical training and professional development for all clinic staff. Specifically, only one of four clinics provided extragenital STI testing, and no clinics reported prescribing Pre-Exposure Prophylaxis (PrEP). Conclusions Rural primary care clinics can fill important gaps in the availability of STI and HIV services with appropriate support and incentives. Findings from this study may aid in facilitating policy (state Medicaid agencies) and program (state health department) decisions related to STI and HIV testing and treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Identifying the Need for and Availability of Evidence-Based Care for Sexually Transmitted Infections in Rural Primary Care Clinics

Merrell,

Crouch,

Harrison

et al. 2023

Sexual Trans Dis

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“…As an example, religion can be a barrier in providing adequate and affirming care to individuals who experience HIV; this highlights that this cultural norm may decrease the quality and availability of care to historically marginalized communities, such as TNB individuals. 23 Combined, these factors may increase the stigma against the TNB community, which then can negatively impact the care delivered.…”

Section: Discussionmentioning

confidence: 99%

The Intersection of Stress, Health, and Health Care Opportunities for Appalachian Transgender and Nonbinary People: An Interpretative Phenomenological Analysis

2023

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Transgender or nonbinary (TNB) individuals in the United States South experience higher rates of physical and mental health disparities when compared to their cisgender counterparts. Societal, interpersonal, and individual stigmas contribute to these disparities by increasing the levels of stress in the TNB population, which is a primary factor in higher morbidity and mortality. However, there is a paucity of research examining the impact of these stigmas on health through the lived experiences of TNB people living in Appalachia. An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in Appalachia. Transcribed interviews were analyzed repeatedly by two analysts to identify emergent themes which focused on understanding an individual's lived experiences through interpretation. Ten participants from four Appalachian states within three Appalachian sub-regions participated in this study. Three shared healthcare themes were identified: experiences of stigma related to gender, the impact of stigma on personal wellbeing and perception of health, and the need for affirming TNB healthcare services. Respondents noted that chronic stress factors such as continual and compounding experiences of stigma and discrimination, stemming from religion or lack of affirming providers, negatively impacted their health. TNB individuals living in Appalachia experience chronic societal, interpersonal, and individual stressors that negatively impact their health. By addressing the stigmas, public health leaders, policymakers, and providers can improve access to health care and the health and quality of life of Appalachian TNB people.

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“…They interviewed care providers, advocates, religious leaders, and public health administrators about the role of religious institutions in HIV service provision for transgender Southerners. 8 Their findings highlighted participants' acknowledgment of pervasive anti-transgender and HIV stigma perpetuated by faith communities' moral judgment toward people of transgender experience and individuals living with HIV. Furthermore, these compounding stigmas were identified as public health concerns affecting transgender people of color in the region.…”

mentioning

confidence: 98%

“…[3][4][5] Among the groups most systematically affected in the U.S. South are individuals whose gender differs from that assigned at birth, including people of transgender, non-binary, and gender nonconforming (TGNC) experience, particularly transgender women and femmes of color. [6][7][8] One study in North and South Carolina explored a socio-cultural factor specific to the South. They interviewed care providers, advocates, religious leaders, and public health administrators about the role of religious institutions in HIV service provision for transgender Southerners.…”

mentioning

confidence: 99%

A Gender Affirmative Model of Training and Service Provision Among HIV Service Organizations in the U.S. South

Keo,

McCormick,

Stanton

et al. 2023

hpu

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Research on gender affirmative models (GAM) of training and service provision is emerging. This study aims 1) to summarize 2018–2019 survey data on GAM training and service provision at Southern HIV Service Organizations (HSOs) in the U.S. South and 2) identify barriers in the region. Methods. Data were collected from Southern HSOs ( n =207). Relations between GAM training and service provision were examined through frequency distributions and logistic regressions. Results. Few (46.6%) received training. Most (73%) used clients' asserted names and pronouns. Only 62% engaged with transgender, nonbinary, and gender nonconforming (TGNC) communities and 55% provided a gender autonomous (i.e., based on self-determination) facility. Gender affirmative model-trained HSOs had at least twice the odds of implementing GAM elements compared with non-trained HSOs. Barriers included funding (61%), expertise/knowledge (59%), capacity/staff-ing (52%), and political climate (23%). Discussion . This study identifies gaps and highlights the urgent need for funding, training, and meaningful TGNC community partnerships.

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“In the Bible Belt:” The role of religion in HIV care and prevention for transgender people in the United States South

Cited by 8 publications

References 55 publications

Identifying the Need for and Availability of Evidence-Based Care for Sexually Transmitted Infections in Rural Primary Care Clinics

Identifying the Need for and Availability of Evidence-Based Care for Sexually Transmitted Infections in Rural Primary Care Clinics

The Intersection of Stress, Health, and Health Care Opportunities for Appalachian Transgender and Nonbinary People: An Interpretative Phenomenological Analysis

A Gender Affirmative Model of Training and Service Provision Among HIV Service Organizations in the U.S. South

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