Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
AIDS Patient Care STDS. 2020 Jan;34(1):7-15. doi: 10.1089/apc.2019.0165.
Young black and Latinx men who have sex with men (YBLMSM) and transgender women (YBLTW) are disproportionately impacted by HIV. Structural and social marginalization, the social barriers, and structures that unevenly distribute benefits and burdens to different groups, may contribute to inability for youth to access prevention and treatment care services. Yet, few reports have examined the community and health care experiences of social marginalization among youth service providers who have multiple roles in the community (i.e., serve as a service provider and are a member or prior member of the YBLMSM and YBLTW population). Eighteen key informants (KIs), defined as youth, young adults, or adults who were members of or connected to the YBLMSM and young black and Latinx transgender (YBLTG) community, participated in a one-time, face-to-face, or telephone key informant interview (KII) lasting ∼45 min. KIs were defined as youth service providers because they described working with the target population and either being a member of or closely connected to the target population. KIs described key themes related to marginalization: lack of competent care among health care providers and both clinical and community spaces that left out key populations. HIV stigma and medical mistrust continues to create a barrier to care in this population and for interventions to be effective interventions will need to use an intersectional approach that simultaneously address all identities, and the social and structural needs of youth.
年轻的男男性行为者和跨性别女性(YBLMSM 和 YBLTW)黑人及拉丁裔青年受到 HIV 的影响不成比例。结构和社会边缘化,即不平等地将利益和负担分配给不同群体的社会障碍和结构,可能导致年轻人无法获得预防和治疗保健服务。然而,很少有报告研究过在社区中具有多种角色的青年服务提供者(即,既是服务提供者,又是 YBLMSM 和 YBLTW 人群的成员或前成员)的社会边缘化的社区和保健经验。18 名关键信息提供者(KIs),定义为青年、年轻成年人或成年人,他们是 YBLMSM 和年轻的黑人及拉丁裔跨性别(YBLTG)社区的成员或与该社区有联系,参加了一次面对面或电话式关键信息提供者访谈(KII),持续约 45 分钟。KIs 被定义为青年服务提供者,因为他们描述了与目标人群合作,并且是目标人群的成员或与目标人群密切相关。KIs 描述了与边缘化相关的关键主题:卫生保健提供者缺乏能力,临床和社区空间都将关键人群排除在外。艾滋病毒耻辱感和医疗不信任感继续在该人群中造成护理障碍,为了使干预措施有效,干预措施将需要采用交叉方法,同时解决所有身份以及青年的社会和结构需求。
Int J Equity Health. 2025-5-6
MMWR Morb Mortal Wkly Rep. 2019-9-20
Curr Opin HIV AIDS. 2019-9
AIDS Patient Care STDS. 2018-12
J Acquir Immune Defic Syndr. 2019-1-1