Department of Health Policy, CUNY School of Public Health, 55 W. 125th St, New York, NY, 10027, USA.
Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
AIDS Behav. 2021 Jul;25(Suppl 1):96-106. doi: 10.1007/s10461-019-02753-9.
This study describes a sample of HIV+ young transgender women of color aged 18-24 and their experience with homelessness as part of a demonstration project of engagement and retention in HIV medical care funded by Health Resources and Services Administration. The study engaged transgender women of color in HIV care in nine sites across the US between 2012 and 2017. This analysis describes and compares transwomen who had been homeless in the last 6 months to those not homeless. We hypothesized that homelessness would compete with HIV care, food, shelter, and be associated with poverty. Variable domains included sociodemographic, mental health and substance use, HIV care, sexual risk behavior, social support from transgender and other friends, and childhood sexual abuse. There were 102 youth enrolled, 77 (75.5%) who had been homeless, and 25 (24.5%) who had not been homeless. Bivariate analyses showed that low income, sex work as source of income, inability to afford food, lack of viral load (VL) suppression, childhood sexual abuse, lower levels of social support, and higher levels of depression were associated with homelessness. A logistic regression model showed that being unable to afford food (AOR = 9.24, 95% CI 2.13-40.16), lack of VL suppression in last 6 months (AOR = 0.10, 95% CI .02-.57), and lack of transgender friend support (AOR = 0.09, 95% CI .02-.53) was associated with homelessness. Programs that place basic needs first-food and shelter-may be able to engage and assist young transgender women of color with HIV to survive and live healthier lives.
本研究描述了一个样本，其中包括年龄在 18-24 岁之间的 HIV 阳性年轻跨性别女性有色人种，以及她们在无家可归方面的经历，这是一项由卫生资源和服务管理局资助的参与和保留艾滋病毒医疗保健示范项目的一部分。该研究在 2012 年至 2017 年间在美国 9 个地点招募了参与艾滋病毒护理的跨性别女性有色人种。本分析描述并比较了过去 6 个月内无家可归的跨性别女性和没有无家可归的跨性别女性。我们假设无家可归会与艾滋病毒护理、食物、住所竞争，并与贫困有关。变量领域包括社会人口统计学、心理健康和物质使用、艾滋病毒护理、性风险行为、来自跨性别和其他朋友的社会支持以及儿童时期的性虐待。共有 102 名青年入组，其中 77 人（75.5%）无家可归，25 人（24.5%）无家可归。双变量分析表明，低收入、性工作作为收入来源、无力负担食物、缺乏病毒载量（VL）抑制、儿童时期的性虐待、较低水平的社会支持和较高水平的抑郁与无家可归有关。逻辑回归模型显示，无力负担食物（AOR=9.24，95%CI 2.13-40.16）、过去 6 个月缺乏 VL 抑制（AOR=0.10，95%CI 0.02-.57）和缺乏跨性别朋友支持（AOR=0.09，95%CI 0.02-.53）与无家可归有关。将基本需求（食物和住所）放在首位的项目可能能够使感染艾滋病毒的年轻跨性别女性有色人种参与并帮助她们生存并过上更健康的生活。
