Mortality rates by gender and sexual orientation reveal a disproportionally high mortality among cisgender men of unknown sexual orientation and men who have sex with women in a cohort of people living with HIV in Rio de Janeiro, Brazil

Coelho, Lara E.; Torres, Thiago Silva; Jalil, Emilia Moreira; Cardoso, Sandra Wagner; Moreira, Ronaldo I.; Calvet, Guilherme Amaral; Pacheco, Antônio Guilherme; Veloso, Valdiléa G.; Grinsztejn, Beatriz; Luz, Paula M.

doi:10.1016/j.bjid.2023.102740

Cited by 3 publications

(5 citation statements)

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“…The cohort at INI/Fiocruz has detailed gender and sexual orientation information, which we have used to understand how the experiences of these population groups differ. 24 , 25 Another limitation of the present study is the lack of regional variation in mortality and other key model parameters that might more accurately reflect Brazil's heterogeneity; thus, our analysis cannot address variation in survival that may result from underlying LE differences between regions. We also did not specifically examine the benefits of tuberculosis prophylaxis as distinct from ART.…”

Section: Discussionmentioning

confidence: 97%

“… 26 Importantly, recent experience at INI/Fiocruz has shown that providing a welcoming, gender-affirming environment with gender-neutral toilets and trans-affirming posters, for example, can improve outcomes for TGW. 25 …”

Section: Discussionmentioning

confidence: 99%

“…Since 2015, INI/Fiocruz has employed multiple strategies to recruit and engage TGW in HIV prevention and care, which have resulted in earlier HIV diagnosis, and as reported in a recent analysis, lower mortality rates compared to other population groups. 25 This may not be representative of the experiences of TGW cared for in other health services in Brazil. Studies from other parts of Brazil have shown that TGW may avoid seeking services because of transphobic experiences which contribute to their increased vulnerability to HIV.…”

Section: Methodsmentioning

confidence: 97%

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Variability in life expectancy among people with HIV in Brazil by gender and sexual orientation

Luz,

Spaeth,

Scott

et al. 2024

The Brazilian Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 97%

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Variability in life expectancy among people with HIV in Brazil by gender and sexual orientation

Luz,

Spaeth,

Scott

et al. 2024

The Brazilian Journal of Infectious Diseases

Self Cite

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“…It was observed that transgender women and those who have sex with other women have higher mortality rates than heterosexual cisgender women. Men, whether they are cisgender or transgender, as well as men who have sex with men, also have a higher risk of dying than heterosexual cisgender women [ 38 – 41 ]. Thus, having established the cutoff point and the best strategies for capturing information in large datasets, it is essential to scrutinize in more detail how sexual and gender markers affect the risk of dying in the population.…”

Section: Discussionmentioning

confidence: 99%

Accuracy, potential, and limitations of probabilistic record linkage in identifying deaths by gender identity and sexual orientation in the state of Rio De Janeiro, Brazil

de Mattos Russo Rafael,

da Silva,

de Souza Santos

et al. 2024

BMC Public Health

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Background Globally, the counting of deaths based on gender identity and sexual orientation has been a challenge for health systems. In most cases, non-governmental organizations have dedicated themselves to this work. Despite these efforts in generating information, the scarcity of official data presents significant limitations in policy formulation and actions guided by population needs. Therefore, this manuscript aims to evaluate the accuracy, potential, and limits of probabilistic data relationships to yield information on deaths according to gender identity and sexual orientation in the State of Rio de Janeiro. Methods This study evaluated the accuracy of the probabilistic record linkage to obtain information on deaths according to gender and sexual orientation. Data from two information systems were used from June 15, 2015 to December 31, 2020. We constructed nine probabilistic data relationship strategies and identified the performance and cutoff points of the best strategy. Results The best data blocking strategy was established through logical blocks with the first and last names, birthdate, and mother’s name in the pairing strategy. With a population base of 80,178 records, 1556 deaths were retrieved. With an area under the curve of 0.979, this strategy presented 93.26% accuracy, 98.46% sensitivity, and 90.04% specificity for the cutoff point ≥ 17.9 of the data relationship score. The adoption of the cutoff point optimized the manual review phase, identifying 2259 (90.04%) of the 2509 false pairs and identifying 1532 (98.46%) of the 1556 true pairs. Conclusion With the identification of possible strategies for determining probabilistic data relationships, the retrieval of information on mortality according to sexual and gender markers has become feasible. Based on information from the daily routine of health services, the formulation of public policies that consider the LGBTQ + population more closely reflects the reality experienced by these population groups.

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“…It was observed that transwomen and those who have sex with other women have higher mortality rates than heterosexual cisgender women. Men, whether they are cisgender or transgender, as well as men who have sex with men, also have a higher risk of dying than heterosexual cisgender women (41)(42)(43)(44). Thus, having established the cutoff point and the best strategies for capturing information in large datasets, it is essential to scrutinize in more detail how sexual and gender markers affect the risk of dying in the population.…”

Section: Discussionmentioning

confidence: 99%

Mortality according to gender identity and sexual orientation: Data relationship strategies for Rio de Janeiro, Brazil

Rafael,

Silva,

Santos

et al. 2024

Preprint

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Objective: To evaluate the accuracy, potential, and limits of probabilistic data relationships to yield information on deaths according to sex identity and sexual orientation in the state of Rio de Janeiro. Methods: This study evaluated the accuracy of the probabilistic relationship of data to obtain information on deaths according to gender and sexual orientation. Data from two information systems were used from June 15, 2015 to December 31, 2020. We constructed nine probabilistic data relationship strategies and identified the performance and cutoff points of the best strategy. Results: The best data blocking strategy was established through logical blocks with the first and last names, birthdate, and mother's name in the pairing strategy. With a population base of 80,178 records, 1556 deaths were retrieved. With an area under the curve of 0.979, this strategy presented 93.26% accuracy, 98.46% sensitivity, and 90.04% specificity for the cutoff point ≥ 17.9 of the data relationship score. The adoption of the cutoff point optimized the manual review phase, identifying 2259 (90.04%) of the 2509 false pairs and identifying 1532 (98.46%) of the 1556 true pairs. A crude mortality rate of 19.11 deaths per 1,000 people was observed, where women who had sex with women, transvestites, and transgender women had higher mortality rates than heterosexual cisgender women. Neither men nor men with gender markers had higher mortality rates than heterosexual cisgender women. Conclusion: With the identification of possible strategies for determining probabilistic data relationships, the retrieval of information on mortality according to sexual and sex markers has become feasible. Based on information from the daily routine of health services, the formulation of public policies that consider the LGBT+ population more closely reflects the reality experienced by these population groups.

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Mortality rates by gender and sexual orientation reveal a disproportionally high mortality among cisgender men of unknown sexual orientation and men who have sex with women in a cohort of people living with HIV in Rio de Janeiro, Brazil

Cited by 3 publications

References 38 publications

Variability in life expectancy among people with HIV in Brazil by gender and sexual orientation

Variability in life expectancy among people with HIV in Brazil by gender and sexual orientation

Accuracy, potential, and limitations of probabilistic record linkage in identifying deaths by gender identity and sexual orientation in the state of Rio De Janeiro, Brazil

Mortality according to gender identity and sexual orientation: Data relationship strategies for Rio de Janeiro, Brazil

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