A life course health development model of HIV vulnerabilities and resiliencies in young transgender women in Peru  

作　　者：Sari L.Reisner Rodrigo A.Aguayo-Romero Amaya Perez-Brumer Ximena Salazar Aron Nunez-Curto Casey Orozco-Poore 

机构地区：[1]Alfonso Silva-Santisteban7Division of General Pediatrics,Boston Children’s Hospital,Boston,MA,USA [2]Division of Endocrinology,Diabetes and Hypertension,Brigham and Women’s Hospital,221 Longwood Ave,5th Fl,Boston,MA 02115,USA [3]Department of Medicine,Harvard Medical School,Boston,MA,USA [4]Department of Epidemiology,Harvard T.H.Chan School of Public Health,Boston,MA,USA [5]The Fenway Institute,Fenway Health,Boston,MA,USA [6]Division of Social and Behavioural Health Sciences,Dalla Lana School of Public Health,University of Toronto Dalla Lana School of Public Health,Toronto,ON,Canada [7]Centro de Investigacion Interdisciplinaria en Sexualidad,Sida y a y Sociedad,Universidad Peruana Cayetano,Lima,Peru

出　　处：《Global Health Research and Policy》2023年第1期212-224,共13页全球健康研究与政策（英文）

基　　金：supported by the National Institute of Mental Health of the National Institutes of Health under award number NIH R21MH118110("HIV risk and psychosocial health among transgender women in Peru";MPI:Reisner&Silva-Santisteban)。

摘　　要：Background Globally transgender women(TW)are at heightened vulnerability for HIV infection.In Lima Peru,sharp increases in HIV prevalence are seen among TW ages 25 years and older highlighting the need for early HIV prevention efforts for young TW.This study conducted in-depth qualitative interviews to elucidate the social and developmental contexts of HIV vulnerability for young TW in Lima Peru.Methods Between November 2019 and February 2020,young TW ages 16-24 years(n=21)in Lima Peru were purposively sampled using in-person(e.g.,face-to-face outreach)and online(e.g.,social media,networking websites)social network-based methods.Interviews were conducted in Spanish and a rapid qualitative analysis was conducted using a modified immersion crystallization methodology to identify themes.Results Five themes emerged,informing the conceptualization of a Life Course Health Development Model of HIV Vulnerabilities and Resiliencies:(1)interpersonal contexts(family,school,partners,sexual debut,trans mothers);(2)structural vulnerabilities(poverty,educational constraints,migration,hostile environments,sex work,police violence);(3)concomitant mental health and psychosocial factors(discrimination,violence,depression,suicidality,substance use,life hopes/dreams/future expectations);(4)gender affirmation processes(gender identity development,hormones,surgery,legal name/gender marker change);(5)HIV prevention and treatment barriers(PrEP uptake,HIV care,condom use,risk reduction).Conclusions Young TW experience formidable developmental challenges associated with transphobia,violence,and pre-maturely facing accelerated milestones.Developmentally and culturally appropriate interventions to mitigate HIV vulnerability in Peru are needed,including those that consider co-occurring stigma-related conditions in adolescence and young adulthood.

关 键 词：HIV prevention TRANSGENDER Latin America YOUTH 

分 类 号：R51[医药卫生—内科学]