10
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Association between gender-based discrimination and medical visits and HIV testing in a large sample of transgender women in northeast Brazil

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Gender-based discrimination remains a substantial barrier to health care access and HIV prevention among transgender women in Brazil. The aim of this study was to investigate the association between gender-based discrimination and medical visits, as well as with HIV testing among transgender women in the last 12 months in northeast Brazil.

          Methods

          This is a cross-sectional study of 864 transgender women recruited using Respondent-Driven Sampling in three cities in northeastern Brazil in 2016. A socio-behavioral questionnaire was applied. Multivariate analyses were performed using logistic regression, with odds ratio and respective 95% confidence intervals estimation, to estimate the effect of gender-based discrimination on two outcomes: i) medical visits and ii) HIV testing in the last 12 months.

          Results

          547 transgender women (67·0%) had medical visits, and 385 (45·8%) underwent HIV testing in the last 12 months. In the multivariate analysis, gender-based discrimination was associated with a reduced likelihood of medical visits (OR: 0·29; 95%CI: 0·14–0·63) and HIV testing (OR: 0·41; 95%CI: 0·22–0·78) in the last 12 months.

          Conclusion

          Gender-based discrimination played an essential role in reducing the access of TGW to medical visits and HIV testing services. Furthermore, by confirming the association between gender-based discrimination and medical visits and HIV testing in the multivariate analysis, we have demonstrated how this predictive variable can affect by reducing access to health services. The findings point to the need for non-discriminatory policies based on the defense and promotion of human rights that may foster the access of transgender women to Brazilian health services.

          Related collections

          Most cited references38

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Regional alcohol consumption and alcohol-related mortality in Great Britain: novel insights using retail sales data

          Background Regional differences in population levels of alcohol-related harm exist across Great Britain, but these are not entirely consistent with differences in population levels of alcohol consumption. This incongruence may be due to the use of self-report surveys to estimate consumption. Survey data are subject to various biases and typically produce consumption estimates much lower than those based on objective alcohol sales data. However, sales data have never been used to estimate regional consumption within Great Britain (GB). This ecological study uses alcohol retail sales data to provide novel insights into regional alcohol consumption in GB, and to explore the relationship between alcohol consumption and alcohol-related mortality. Methods Alcohol sales estimates derived from electronic sales, delivery records and retail outlet sampling were obtained. The volume of pure alcohol sold was used to estimate per adult consumption, by market sector and drink type, across eleven GB regions in 2010–11. Alcohol-related mortality rates were calculated for the same regions and a cross-sectional correlation analysis between consumption and mortality was performed. Results Per adult consumption in northern England was above the GB average and characterised by high beer sales. A high level of consumption in South West England was driven by on-trade sales of cider and spirits and off-trade wine sales. Scottish regions had substantially higher spirits sales than elsewhere in GB, particularly through the off-trade. London had the lowest per adult consumption, attributable to lower off-trade sales across most drink types. Alcohol-related mortality was generally higher in regions with higher per adult consumption. The relationship was weakened by the South West and Central Scotland regions, which had the highest consumption levels, but discordantly low and very high alcohol-related mortality rates, respectively. Conclusions This study provides support for the ecological relationship between alcohol-related mortality and alcohol consumption. The synthesis of knowledge from a combination of sales, survey and mortality data, as well as primary research studies, is key to ensuring that regional alcohol consumption, and its relationship with alcohol-related harms, is better understood.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Worldwide burden of HIV in transgender women: a systematic review and meta-analysis

            The Lancet Infectious Diseases, 13(3), 214-222
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention.

              This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to-male transgender persons and determined factors associated with HIV. We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR = 2.69; 95% CI = 1.56, 4.62), multiple sex partners (adjusted OR = 2.64; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI = 1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services.
                Bookmark

                Author and article information

                Contributors
                leitebeo@gmail.com
                daniellesoutomedeiros@gmail.com
                laiomagnoss@gmail.com
                francisco.inacio.bastos@hotmail.com
                coutinho.carol@gmail.com
                anabrito1009@gmail.com
                socorro.cavalcante@gmail.com
                ines.dourado@gmail.com
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                6 September 2021
                6 September 2021
                2021
                : 20
                : 199
                Affiliations
                [1 ]GRID grid.8399.b, ISNI 0000 0004 0372 8259, Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, ; Bahia, Brazil
                [2 ]GRID grid.8399.b, ISNI 0000 0004 0372 8259, Collective Health Institute, Federal University of Bahia. Av. Basílio da Gama, ; s/nCampus Universitário do Canela, Salvador, Bahia 40110-040 Brazil
                [3 ]GRID grid.442053.4, ISNI 0000 0001 0420 1676, Life Sciences Department, , Bahia State University, ; Campus1, Salvador, Bahia Brazil
                [4 ]GRID grid.418068.3, ISNI 0000 0001 0723 0931, Oswaldo Cruz Foundation, ; Rio de Janeiro, Rio de Janeiro Brazil
                [5 ]GRID grid.452413.5, ISNI 0000 0001 0720 8347, Getúlio Vargas Foundation, ; São Paulo, São Paulo Brazil
                [6 ]GRID grid.418068.3, ISNI 0000 0001 0723 0931, Aggeu Magalhães Institute. Oswaldo Cruz Foundation, ; Recife, Brazil
                [7 ]Ceará State Health Secretariat and Municipality of Fortaleza, Fortaleza, Brazil
                Author information
                http://orcid.org/0000-0002-4137-9809
                Article
                1541
                10.1186/s12939-021-01541-z
                8422640
                34488781
                3c076091-13eb-4a62-9847-87c6a42a2c5b
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 15 June 2021
                : 24 August 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100006506, Ministério da Saúde;
                Award ID: Nº11/2018
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Health & Social care
                transgender women,discrimination,stigma,use of health services,hiv testing
                Health & Social care
                transgender women, discrimination, stigma, use of health services, hiv testing

                Comments

                Comment on this article