University of Southern California, Dornsife College of Letters, Arts, and Sciences, Spatial Sciences Institute, 3616 Trousdale Parkway, AHF B55, Los Angeles, CA, 90089, USA.
McGill University, School of Social Work, 3506 University St., Suite 300, Wilson Hall, Montreal, Quebec, H3A 2A7, Canada.
Soc Sci Med. 2022 Jan;292:114610. doi: 10.1016/j.socscimed.2021.114610. Epub 2021 Nov 27.
This paper presents results of a research priority setting process focused on trans women living with and affected by HIV across Canada. It features data from semi-structured interviews and focus groups conducted with a diverse group of 76 trans women in five urban centers across the country on how they have navigated health and social service programming within their geographic context. The results focus on the structure and types of services. Respondents offered simple, yet creative ways to address barriers to vital services based on their individual and collective experiences. Notably, participants stressed the need for 1) trans-friendly and trans-specific services, 2) integrated health services, and aid in navigating complex, overlapping systems, and 3) comprehensive community-based services. They also suggest employing trans women as care coordinators or case managers in order to foster more trans-friendly environments and empower community members. We identify concrete ways to improve health and social services at the level of service delivery and program design, as well as recommendations for future participatory research. We close with an interrogation of trans people, and trans women living with and affected by HIV in particular, as 'hard to reach' populations.
本文呈现了一项针对加拿大各地感染艾滋病毒的跨性别女性的研究重点设定过程的结果。该研究采用半结构式访谈和焦点小组的方法，在全国五个城市中心与 76 名不同背景的跨性别女性进行了合作，了解她们在各自的地理环境中如何利用卫生和社会服务项目。研究结果侧重于服务的结构和类型。受访者根据自己的个人和集体经验，提供了一些简单但有创意的方法来解决关键服务的障碍。值得注意的是，参与者强调需要 1）对跨性别者友好和特定于跨性别者的服务，2）整合的卫生服务，并帮助他们了解复杂且重叠的系统，以及 3）全面的基于社区的服务。他们还建议雇用跨性别女性作为护理协调员或个案经理，以营造更对跨性别者友好的环境，并赋予社区成员权力。我们确定了在服务提供和项目设计层面上改善卫生和社会服务的具体方法，以及对未来参与性研究的建议。最后，我们探讨了跨性别者，特别是感染艾滋病毒的跨性别女性，作为“难以接触”的人群。
