Radusky Pablo D, Zalazar Virginia, Cardozo Nadir, Fabian Solange, Duarte Mariana, Frola Claudia, Cahn Pedro, Sued Omar, Aristegui Inés
Research Department, Fundación Huésped, Buenos Aires, Argentina.
Faculty of Psychology, Universidad de Buenos Aires, Buenos Aires, Argentina.
Transgend Health. 2020 Dec 11;5(4):216-224. doi: 10.1089/trgh.2020.0005. eCollection 2020 Dec.
Stigma toward transgender women (TGW) increases psychosocial vulnerability, leading to poor mental health and affecting access and retention in HIV care. Trans-sensitive health care (TSHC) has the potential to mitigate this adverse impact. This study aimed to describe baseline characteristics in gender identity stigma (GIS), mental health, and substance use among TGW living with HIV initiating antiretroviral treatment and to analyze changes after 6 months in HIV care in a TSHC clinic in Argentina. Sixty-one TGW living with HIV responded to the following questionnaires at baseline and after 6 months in TSHC: sociodemographic, experiences of GIS (in health care, police, etc.), Center for Epidemiologic Studies Depression Scale (CES-D) (depression), State Trait Anxiety Inventory (STAI) (anxiety), Drug Abuse Screening Test (DAST-10) (drug use), Alcohol Use Disorders Identification Test (AUDIT) (alcohol use), 8-item Personal Wellbeing Index-Adults (PWI-A) (quality of life [QOL]), Personality Inventory for DSM-5-Brief Form (PID-5-BF) (maladaptive personality traits), and Duke Index (social support). Analyses included Pearson correlations to analyze associations between variables; and paired sample -tests, to explore changes between baseline and 6 months. A significant proportion experienced episodes of GIS the last year in any context. At baseline, 50.8% showed significant depressive symptoms and 65.6% reported any drug use in the last year. At 6 months, participants experienced a significant reduction of GIS, both enacted and internalized, anxiety, drug, and alcohol use, and improvement in QOL. The remaining mental health indicators were not significantly modified. A TSHC service may have a gender-affirmative impact on TGW initiating HIV care that contributes to reduce GIS and substance use and improve mental health. This highlights the importance that HIV care programs for TGW comply with trans-sensitive essential components to enhance retention.
对跨性别女性（TGW）的污名化增加了心理社会脆弱性，导致心理健康状况不佳，并影响获得和维持艾滋病毒治疗。跨性别敏感医疗保健（TSHC）有减轻这种不利影响的潜力。本研究旨在描述开始接受抗逆转录病毒治疗的感染艾滋病毒的TGW的性别认同污名（GIS）、心理健康和物质使用的基线特征，并分析阿根廷一家TSHC诊所接受艾滋病毒治疗6个月后的变化。61名感染艾滋病毒的TGW在TSHC的基线和6个月后对以下问卷做出了回应：社会人口统计学、GIS经历（在医疗保健、警察等方面）、流行病学研究中心抑郁量表（CES-D）（抑郁）、状态特质焦虑量表（STAI）（焦虑）、药物滥用筛查测试（DAST-10）（药物使用）、酒精使用障碍识别测试（AUDIT）（酒精使用）、成人8项个人幸福指数（PWI-A）（生活质量[QOL]）、精神疾病诊断与统计手册第5版简表人格量表（PID-5-BF）（适应不良人格特质）和杜克指数（社会支持）。分析包括Pearson相关性分析变量之间的关联；以及配对样本t检验，以探索基线和6个月之间的变化。很大一部分人在去年的任何情况下都经历过GIS事件。基线时，50.8%的人表现出明显的抑郁症状，65.6%的人报告去年有过任何药物使用。在6个月时，参与者经历了GIS、实施的和内化的、焦虑、药物和酒精使用的显著减少，以及生活质量的改善。其余心理健康指标没有显著变化。TSHC服务可能对开始接受艾滋病毒治疗的TGW产生性别肯定影响，有助于减少GIS和物质使用，并改善心理健康。这凸显了针对TGW的艾滋病毒治疗项目符合跨性别敏感基本要素以提高留存率的重要性。
