Takahashi Lois M, Tobin Karin, Li Fang-Ying, Proff Abigail, Candelario Jury
Sol Price School of Public Policy, University of Southern California, Sacramento, California, USA.
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Int J Transgend Health. 2020 Sep 25;23(1-2):232-242. doi: 10.1080/15532739.2020.1819508. eCollection 2022.
Transgender women of Color experience disproportionate rates of HIV, depression, and anxiety, and high rates of substance use, attempted suicide, and interpersonal verbal, physical, and sexual violence and assault. However, there are few interventions targeting transgender women of Color that address overlapping health and mental health challenges. There are two aims/research questions: (1) what are the elements of a transgender-centric model for delivering evidence based interventions and practices?, and (2) does Seeking Safety improve substance use and mental health outcomes for transgender women of Color? We present a case study of the delivery process of Seeking Safety by Special Service for Groups/Asian Pacific AIDS Intervention Team (SSG/APAIT), and analyze baseline and three month post program participant data (n = 81). The transgender-centric model of intervention delivery consisted of multiple steps, also integrating the structural disadvantages experienced by transgender women of Color. Comparing baseline and three months after completion showed significant decrease in reported alcohol use, depression, and severe anxiety. Transgender-centric approaches may lead to programs that significantly improve co-occurring substance use and mental health for transgender women of Color. We recommend that organizations aiming to existing programs include feedback from members of the communities that the adapted programs aim to help, and in addition, train community members to deliver the programs. The statistical results indicate that Seeking Safety, a trauma-based program with a short program delivery timeline, may show longer term effects on substance use and mental health. We recommend that programs targeting substance use and mental health for transgender women of Color should be combined with services that address disadvantage (i.e., lack of access to housing, income/employment, health care).
有色人种跨性别女性感染艾滋病毒、患抑郁症和焦虑症的比例过高,且存在药物滥用、自杀未遂以及人际间言语、身体和性暴力及攻击的高发生率。然而,针对有色人种跨性别女性且能应对重叠的健康和心理健康挑战的干预措施却很少。有两个目标/研究问题:(1)以跨性别者为中心的模式提供循证干预措施和实践的要素有哪些?(2)“寻求安全”项目能否改善有色人种跨性别女性的药物使用和心理健康状况?我们呈现了群体特殊服务/亚太艾滋病干预团队(SSG/APAIT)实施“寻求安全”项目的案例研究,并分析了项目参与者的基线数据和项目结束三个月后的相关数据(n = 81)。以跨性别者为中心的干预实施模式包括多个步骤,还整合了有色人种跨性别女性所经历的结构性劣势。比较基线数据和项目完成三个月后的情况,报告显示酒精使用、抑郁和严重焦虑显著减少。以跨性别者为中心的方法可能会带来一些项目,显著改善有色人种跨性别女性同时存在的药物使用和心理健康状况。我们建议,旨在改进现有项目的组织应纳入适应项目旨在帮助的社区成员的反馈,此外,培训社区成员来实施这些项目。统计结果表明,“寻求安全”这个基于创伤且项目实施时间较短的项目,可能对药物使用和心理健康有长期影响。我们建议,针对有色人种跨性别女性药物使用和心理健康的项目应与解决劣势问题(即缺乏住房、收入/就业、医疗保健机会)的服务相结合。