Unevenness in Health at the Intersection of Gender and Sexuality: Sexual Minority Disparities in Alcohol and Drug Use Among Transwomen in the San Francisco Bay Area

Arayasirikul, Sean; Pomart, W. Andres; Raymond, H. Fisher; Wilson, Erin C.

doi:10.1080/00918369.2017.1310552

Cited by 21 publications

(11 citation statements)

References 54 publications

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“…Bullying also partially explained higher rates of alcohol and drug use [74]. Among transfeminine youth (assigned male at birth and identify on a feminine-spectrum), experiences of gender-related discrimination increased the odds of alcohol use compared to transfeminine youth without such experiences [75]; sexual-minority transfeminine youth showed even higher odds of HED than heterosexual transfeminine youth [76]. Internalizing symptoms and felt stigma were also related to alcohol and drug use among GMY.…”

Section: Resultsmentioning

confidence: 99%

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

et al. 2018

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Purpose of Review: Alcohol and drug use are common among youth. Rates are especially high among sexual and gender minority youth (SGMY; lesbian, gay, bisexual, transgender). We conducted a scoping review of research on risk and protective factors for substance use among SGMY published between 2013–2017. Recent Findings: Ninety-seven studies met our inclusion criteria. Most focused on individual-level minority stress risk factors, particularly stigma. Fewer studies addressed protective factors such as social support or affirming policies, and few focused on gender minority youth (GMY). We identified important, yet understudied differences by race/ethnicity, sex assigned at birth, and sexual orientation. Summary: Findings highlight growing interest in this topic as well as methodological/topical gaps in the literature. Research is needed to examine SGMY substance use in nationally representative samples; expand information about GMY; investigate racial/ethnic and sex/gender differences; improve measurement; and increase translation of findings to support prevention and treatment interventions for this at-risk population.

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Section: Resultsmentioning

confidence: 99%

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

et al. 2018

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“…Half of the papers reviewed (51%) did not report transgender-specific prevalence estimates of alcohol outcomes. Among the papers that did, prevalence of binge drinking ranged from 7%-61% (Arayasirikul et al, 2017; Horvath et al, 2014), the proportion reporting drinking to intoxication was 25%-58% (Hotton et al, 2013; Operario et al, 2014), and the prevalence of sexual risk behaviors while intoxicated was 32%-53% (Garofalo, 2006; Santos et al, 2014). Only one paper presented disaggregated findings for transgender men, transgender women, and genderqueer/non-binary individuals (Smalley et al, 2016).…”

Section: Review Of Current Researchmentioning

confidence: 99%

Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies

Gilbert

Pass

Keuroghlian

et al. 2018

Drug and Alcohol Dependence

119

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Given findings that suggest high need for ongoing public health attention, we offer recommendations to improve future alcohol studies with transgender and other gender minority populations, such as being explicit as to whether and how sex and/or gender are operationalized and relevant for the research question, expanding the repertoire of alcohol measures to include those not contingent on sex or gender, testing the psychometric performance of established screening instruments with transgender populations, and shifting from descriptive to analytic study designs.

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“…Sex work, which is the main source of livelihood for majority of the trans-women (4,5), is usually associated with high-risk behaviours such as incorrect and inconsistent condom use, having sex under in uence of drugs and other substance abuse (6,7), and multiple sexual partnerships/relationships (8), which are all known to escalate the risk of HIV transmission (9,10). Thus, trans-women sex workers, who are the focus of this study, experience higher rates of STIs including HIV compared to non-transwomen sex workers (5,11).…”

Section: Introductionmentioning

confidence: 99%

Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda.

Ssekamatte

Isunju

Muyanga³

et al. 2020

Preprint

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BackgroundTrans-women sex workers bear the greatest brunt of HIV and other sexually transmitted infections (STI). Trans-women are 49 times more at risk of HIV infections compared to the general population. However, they remain underserved and continue to grapple with access to and utilisation of HIV/STI prevention services. This study explored barriers to access and utilisation of HIV/STI prevention services and associated coping mechanisms. MethodsThis exploratory qualitative study was conducted among trans-women sex workers in the Greater Kampala Metropolitan area, Uganda. A total of 22 in-depth interviews, 6 key informant interviews and 9 focus group discussions were conducted to obtain data on barriers to access and utilisation of HIV and other STI prevention and care services, and coping strategies of trans-women sex workers. Data were analysed through thematic analysis using a hybrid of inductive and deductive approaches.ResultsIndividual level barriers to access and utilisation of HIV/STI prevention and care services included internalised stigma and low socio-economic status. Health system barriers included social exclusion and lack of recognition by other key population groups; stigmatisation by some healthcare providers; breach of confidentiality by some healthcare providers; limited hours of operation of some key population-friendly healthcare facilities; discrimination by straight patients and healthcare providers; stockout of STI drugs; inadequate access to well-equipped treatment centres and high cost of drugs. At community level, transphobia hindered access and utilisation of HIV/STI prevention and care services. The coping strategies included use of substitutes such as lotions, avocado or yoghurt to cope with a lack of lubricants. Herbs were used as substitutes for STI drugs, while psychoactive substances were used to cope with stigma and discrimination, and changing the dress code to hide their preferred gender identity. Conclusions Individual, community and health system level barriers hindered access and utilisation of HIV/STI prevention and care services among the trans-women sex workers. There is a need to create an enabling environment in order to enhance access to and utilisation of HIV/STI prevention and care services for trans-women sex workers through sensitisation of healthcare providers, other key population groups and the community at large on the transgender identity.

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Unevenness in Health at the Intersection of Gender and Sexuality: Sexual Minority Disparities in Alcohol and Drug Use Among Transwomen in the San Francisco Bay Area

Cited by 21 publications

References 54 publications

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies

Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda.

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