Prevalence and correlates of current cigarette smoking among transgender women in Argentina.

Objective: To assess the prevalence of current cigarette smoking among transgender women in Argentina, and to examine the unique associations of current cigarette smoking with demographic and psychosocial factors. Methods: This study is a secondary data analysis of the TransCITAR - a prospective cohort study of transgender individuals living in Buenos Aires, Argentina - baseline data. The baseline survey collected information on sociodemographic characteristics, perceived health status, depressive symptoms, suicide attempts, current cigarette smoking, alcohol use disorder, and substance use. Participants were also asked about lifetime experiences of physical and sexual violence perpetrated by partners, clients and/or the police, and experiences of gender identity stigma in the past year from healthcare workers and the police. Lastly, participants were asked if they had ever been arrested. Fisher's exact test was used to compare proportions in categorical variables and student t-test was used for continuous variables. Significant associations with current cigarette smoking were tested in a logistic regression model adjusted for all significant associations. Results: A total of 41.7% of participants (n = 393) reported current cigarette smoking. Compared to their non-smoking counterparts, participants who reported current cigarette smoking (1) had completed less education, (2) were more likely to be born in Argentina, (3) more likely to had migrated to Buenos Aires from other parts of the country, (4) more likely to report a history of sex work, (5) more likely to perceive their health as excellent, (6) more likely to screen positive for hazardous alcohol drinking, (7) more likely to report any substance and cocaine use in the past year, (8) more likely to experience gender identity stigma from the police in the past year, and (9) more likely to being arrested in their lifetime (all p's < 0.05). After controlling for all significant associations, education level of less than high school (AOR = 1.79, 95% CI 1.02-2.12), hazardous drinking (AOR = 2.65, 95% CI 1.30-5.37), and any substance use in the last year (AOR = 2.14, 95% CI 1.16-3.94) were positively and independently associated with current cigarette smoking. Conclusion: Among transgender women in Argentina, current cigarette smoking was more than double the rate for cisgender women. Current cigarette smoking was associated with education, hazardous drinking, and any drug use. These results will inform future smoking cessation interventions among transgender women in Argentina.

"If I'm at home, I do it at home": Qualitative study on HIV self-testing among transgender women in Argentina.

BACKGROUND: Evidence among key populations supports acceptability of HIV self-testing (HIVST) due to its privacy and convenience. However, insufficient research has been done among transgender women (TGW), especially in Latin America. Consequently, the aim of this study was to explore the acceptability, perceptions and recommendations for HIVST implementation among TGW in Buenos Aires. METHODS: A focus group was conducted in July 2019. Particpants were invited to touch and learn about a displayed HIVST kit. The following main topics were explored: acceptability, reasons for seeking self-testing, preferences for training, distribution, periodicity and recommendations for HIVST implementation. RESULTS: The sample consisted of 12 TGWs; mean age of 26 years (IQR = 22-28); 66% had history of sex-work. The main motivations for seeking HIVST were convenience, privacy, and usage to reduce stigma and discrimination by health-care providers. Recommendations for HIVST were: distribution from primary health centers and trans-sensitive centers; affordable price; assistance by peer health promoters; and the provision of clear written and video instructions. CONCLUSIONS: Tailored implementation of HIVST can increase HIV testing rates, early detection, and linkage to HIV-care in this high-prevalence group. This study provided community-driven suggestions to inform and adapt an HIVST feasibility pilot study and future implementation in Argentina.

Navegadores pares como "puentes" entre las personas trans y el sistema de salud: sistematización de roles y competencias / Peer navigators as "bridges" between trans people and the health system: systematization of roles and competencies

El estigma y la discriminación llevan a la población trans a evitar acercarse a los servicios de salud. Les navegadores pares (NP) son personas de la comunidad insertas en el equipo de salud que construyen "puentes" entre ambos. Aunque los servicios reconocen cada vez más su importancia, no hay una guía específica y su rol no está bien definido. Este trabajo sistematiza la experiencia y competencias de tres NP en un servicio de atención de VIH en Buenos Aires, Argentina. Esta sistematización resalta la necesidad tanto de incrementar el número de NP con estas competencias específicas, asignando más recursos para incorporar NP con competencias específicas en salud y replicar su rol en otros sectores, como de promover su participación en la planificación e implementación de programas para población

Stigma and discrimination hinder trans population' access to health services. Peer navigators (PN) are people from the community working with the health system, building "bridges" between the two. Although services increasingly recognize their importance, there is no specific guide and their role is not well defined. This work systematizes the experience and skills of three NPs in an HIV care service in Buenos Aires. This systematization highlights the need to increase the number of NP with these specific competencies; allocating more resources to incorporate NP, with specific competencies, in health and replicate its role in other sectors; as well as increasing their participation in planning and implementation of programs for the population.Key words: transgender persons, health services, patient navigation, Argentina.Peer navigators as "bridges"