多米尼加共和国感染艾滋病毒的变性女性性工作者和顺性别女性性工作者之间的耻辱感与艾滋病毒感染状况比较
Comparing Stigma and HIV Outcomes Between Transgender and Cisgender Women Sex Workers Living with HIV in the Dominican Republic.
作者信息
Goldenberg Tamar, Karver Tahilin, Kerrigan Deanna, Gomez Hoisex, Perez Martha, Donastorg Yeycy, Barrington Clare
机构信息
Department of Public Health Education, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, North Carolina, USA.
Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
出版信息
Transgend Health. 2024 Jun 17;9(3):232-240. doi: 10.1089/trgh.2022.0099. eCollection 2024 Jun.
PURPOSE
Using an intersectionality framework, we compared stigma and HIV care and treatment outcomes across transgender and cisgender women sex workers living with HIV in the Dominican Republic (DR).
METHODS
In 2018-2019, data were collected in Santo Domingo, DR, using interviewer-administered surveys among 211 cisgender women and 100 transgender women. We used -tests and chi-square tests to examine differences in sex work stigma, HIV stigma, and HIV care and treatment.
RESULTS
Transgender participants reported more anticipated HIV stigma (mean=13.61, standard deviation [SD]=2.39) than cisgender participants (mean=12.96, SD=2.21; =0.018), but there were no statistically significant differences for internalized or enacted HIV stigma. Cisgender participants reported more anticipated sex work stigma (cisgender: mean=50.00, SD=9.22; transgender: mean=44.02, SD=9.54; <0.001), but transgender women reported more enacted (cisgender: mean=49.99, SD=9.11; transgender: mean=59.93, SD=4.89; <0.001) and internalized sex work stigma (cisgender: mean=50.00, SD=8.80; transgender: mean=57.84, SD=8.34; <0.001), with no significant differences in resistance to sex work stigma. Cisgender women were significantly more likely to have received HIV care (cisgender: 99.53%, transgender: 91.00%, <0.001), be currently taking antiretroviral therapy (cisgender: 96.21%, transgender: 84.00%, <0.001), and be virally suppressed (cisgender: 76.19%, transgender: 64.00%, =0.025).
CONCLUSIONS
Transgender participants consistently had poorer HIV care and treatment outcomes compared with cisgender participants. Differences in stigma experiences between transgender and cisgender participants depended on the type of stigma. Findings reflect the intersectional nature of distinct types and forms of stigma among sex workers. Understanding the shared and unique experiences of transgender and cisgender women will improve HIV care engagement and viral suppression.
目的
运用交叉性框架，我们比较了多米尼加共和国（DR）感染艾滋病毒的跨性别女性和异性恋女性性工作者的耻辱感以及艾滋病毒护理和治疗结果。
方法
2018 - 2019年，在多米尼加共和国圣多明各，通过访员管理的调查收集了211名异性恋女性和100名跨性别女性的数据。我们使用t检验和卡方检验来研究性工作耻辱感、艾滋病毒耻辱感以及艾滋病毒护理和治疗方面的差异。
结果
跨性别参与者报告的预期艾滋病毒耻辱感（均值 = 13.61，标准差[SD] = 2.39）高于异性恋参与者（均值 = 12.96，SD = 2.21；p = 0.018），但在内化或表现出的艾滋病毒耻辱感方面没有统计学上的显著差异。异性恋参与者报告的预期性工作耻辱感更高（异性恋：均值 = 50.00，SD = 9.22；跨性别：均值 = 44.02，SD = 9.54；p < 0.001），但跨性别女性报告的表现出的（异性恋：均值 = 49.99，SD = 9.11；跨性别：均值 = 59.93，SD = 4.89；p < 0.001）和内化的性工作耻辱感更高（异性恋：均值 = 50.00，SD = 8.80；跨性别：均值 = 57.84，SD = 8.34；p < 0.001），在对性工作耻辱感的抵抗方面没有显著差异。异性恋女性接受艾滋病毒护理的可能性显著更高（异性恋：99.53%，跨性别：91.00%，p < 0.001），目前正在接受抗逆转录病毒治疗的可能性也更高（异性恋：96.21%，跨性别：84.00%，p < 0.001），并且病毒得到抑制的可能性也更高（异性恋：76.19%，跨性别：64.00%，p = 0.025）。
结论
与异性恋参与者相比，跨性别参与者的艾滋病毒护理和治疗结果一直较差。跨性别和异性恋参与者在耻辱感经历上的差异取决于耻辱感的类型。研究结果反映了性工作者中不同类型和形式耻辱感的交叉性本质。了解跨性别和异性恋女性的共同和独特经历将改善艾滋病毒护理参与度和病毒抑制情况。
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