Social Network Organization, Structure, and Patterns of Influence Within a Community of Transgender Women in Lima, Peru: Implications for Biomedical HIV Prevention

Clark, Jesse L.; Perez-Brumer, Amaya; Reisner, Sari L.; Salazar, Ximena; McLean, Sarah; Huerta, Leyla; Silva-Santisteban, Alfonso; Moriarty, Kathleen; Mimiaga, Matthew J.; Sánchez, Jorge; Mayer, Kenneth H.; Lama, Javier R.

doi:10.1007/s10461-019-02506-8

Cited by 20 publications

(17 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both groups preferentially discussed HIV and STI prevention with SNMs whose sexual orientations and gender identities aligned with their own: Among MSM, discussions were most frequent with SNMs from the gay and bisexual community, while trans women communicated most with others perceived as transgender. These results signal the importance of homophily in discussions about HIV and STIs and highlight the role of peers as sources of sexual health information [15,16]. However, as peer discussions often address HIV/STI risk only superficially, greater attention toward the content and impact of community-level sexual health communication is warranted [15,16].…”

Section: Discussionmentioning

confidence: 80%

“…These results signal the importance of homophily in discussions about HIV and STIs and highlight the role of peers as sources of sexual health information [15,16]. However, as peer discussions often address HIV/STI risk only superficially, greater attention toward the content and impact of community-level sexual health communication is warranted [15,16].…”

Section: Discussionmentioning

confidence: 80%

“…Within Latin America, prior research has described the ways in which social networks serve as sources of support, information, and influence among MSM and trans women [ 15 , 16 ]. Social and sexual interactions may serve to disseminate knowledge and resources about HIV or STI prevention through MSM and trans women’s networks, where gender identity, sexual orientation, and sexual role may influence awareness of and engagement with HIV/STI prevention resources [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Prior research with this cohort has suggested that CAI is frequent and sexual communication with partners, limited [ 23 ]; thus, understanding the social environments experienced by these communities may provide insight into positive and negative influences on sexual behavior and opportunities for intervention [ 15 ]. In this analysis, we aimed to characterize key social network members (SNMs) within the social networks of Peruvian MSM and trans women; explore perceptions of SNM opinions toward sexual health behaviors; and examine associations of SNM attitudes and characteristics with CAI.…”

Section: Introductionmentioning

confidence: 99%

“…However, other literature points to the need to consider social relationship characteristics and individual or peer identities in network dynamics, communication patterns, and relationship to sexual health. Gender and sexual identity, sexual role, and relationship type may influence peer discussions about topics such as HIV [3,[15][16][17]. The effect of close contacts' opinions about sexual health may in turn vary with patterns of communication, as well as broader network and partnership contexts [20].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Sexual health norms and communication patterns within the close social networks of men who have sex with men and transgender women in Lima, Peru: a 2017 cross-sectional study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social network members (SNMs), participant perceptions of these network members’ opinions toward sexual health behaviors, and associations between network member characteristics and condomless anal intercourse (CAI). Methods In a 2017 cross-sectional study, a convenience sample of 565 MSM and trans women with HIV-negative or unknown serostatus was asked to identify three close SNMs; describe discussions about HIV and STI prevention with each; and report perceived opinions of condom use, HIV/STI testing, and partner notification of STIs. Generalized estimating equations evaluated relationships between SNM characteristics, opinions, and discussions and participant-reported CAI. Results Among participants who identified as MSM, 42.3% of key SNMs were perceived to identify as gay. MSM “never” discussed HIV and STI prevention concerns with 42.4% of heterosexual SNMs, but discussed them “at least once weekly” with 16.9 and 16.6% of gay- and bisexual- identifying SNMs, respectively. Among participants who identified as trans women, 28.2% of key SNMs were perceived as heterosexual; 25.9%, as bisexual; 24.7%, as transgender; and 21.2%, as gay. Trans women discussed HIV/STI prevention least with cis-gender heterosexual network members (40.2% “never”) and most with transgender network members (27.1% “at least once weekly”). Participants perceived most of their close social network to be completely in favor of condom use (71.2% MSM SNMs, 61.5% trans women SNMs) and HIV/STI testing (73.1% MSM SNMs, 75.6% trans women SNMs), but described less support for partner STI notification (33.4% MSM SNMs, 37.4% trans women SNMs). Most participants reported CAI with at least one of their past three sexual partners (77.5% MSM, 62.8% trans women). SNM characteristics were not significantly associated with participant-reported frequency of CAI. Conclusions Findings compare social support, perceived social norms, and discussion patterns of Peruvian MSM and trans women, offering insight into social contexts and sexual behaviors. Trial registration The parent study from which this analysis was derived was registered at ClinicalTrials.gov (Identifier: NCT03010020) on January 4, 2017.

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sexual health norms and communication patterns within the close social networks of men who have sex with men and transgender women in Lima, Peru: a 2017 cross-sectional study

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

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.

View full text Add to dashboard Cite

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.

show abstract

TransPrEP: Results from the Pilot Study of a Social Network-Based Intervention to Support PrEP Adherence Among Transgender Women in Lima, Peru

et al. 2021

View full text Add to dashboard Cite

Social Network Organization, Structure, and Patterns of Influence Within a Community of Transgender Women in Lima, Peru: Implications for Biomedical HIV Prevention

Cited by 20 publications

References 55 publications

Sexual health norms and communication patterns within the close social networks of men who have sex with men and transgender women in Lima, Peru: a 2017 cross-sectional study

Sexual health norms and communication patterns within the close social networks of men who have sex with men and transgender women in Lima, Peru: a 2017 cross-sectional study

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

TransPrEP: Results from the Pilot Study of a Social Network-Based Intervention to Support PrEP Adherence Among Transgender Women in Lima, Peru

Contact Info

Product

Resources

About