a Department of Medicine, Division of Prevention Sciences , University of California , San Francisco , CA , USA.
b Department of Health Policy, Planning, and Administration , Institute of Social Medicine, State University of Rio de Janeiro , Rio de Janeiro , Brazil.
Cult Health Sex. 2019 May;21(5):543-558. doi: 10.1080/13691058.2018.1496277. Epub 2018 Oct 31.
In Brazil, little data is available to inform HIV prevention programming for travestis and transgender ('trans') women, despite the existence of a social movement that has gained strength in recent years. We conducted formative research in Rio de Janeiro to gather trans women's perspectives on combination HIV prevention approaches. Framing the analysis within the model of gender affirmation, we found that several social and contextual factors inhibited participants' access to HIV prevention and treatment. Experienced and anticipated gender-related discrimination and HIV stigma were linked to the avoidance of HIV testing, health services and HIV status disclosure. Participants recommended HIV prevention interventions which combined socio-structural interventions, such as peer-based empowerment and social support, with biomedical interventions such as pre-exposure prophylaxis (PrEP). Participants expressed a preference for programmes and interventions that emphasised a gender-affirmative approach, promoted autonomy and aimed to reduce stigma and discrimination in public health services.
在巴西，针对变装者和跨性别（“跨性别”）女性的艾滋病毒预防规划几乎没有数据，尽管近年来社会运动的力量有所增强。我们在里约热内卢进行了基础研究，以收集跨性别女性对艾滋病毒综合预防方法的看法。在性别肯定模型的框架内进行分析，我们发现几个社会和环境因素阻碍了参与者获得艾滋病毒预防和治疗。经历和预期的与性别相关的歧视和艾滋病毒耻辱感与避免艾滋病毒检测、卫生服务和艾滋病毒状况披露有关。参与者建议将社会结构性干预措施（如基于同伴的赋权和社会支持）与生物医学干预措施（如暴露前预防（PrEP））相结合的艾滋病毒预防干预措施。参与者表示，他们更喜欢强调性别肯定方法、促进自主性并旨在减少公共卫生服务中的耻辱和歧视的方案和干预措施。
