Preference for long-acting injectable for ART and PrEP among people with and without HIV: a cross-sectional study in Argentina.

Background: Little is known about the preferences for antiretroviral therapy (ART) administration methods, such as oral daily pills or long-acting injectable (LAI) options, as well as preferences for pre-exposure prophylaxis (PrEP) administration methods among people without HIV in Latin America. Objectives: This study aimed to assess the preferences for ART administration methods among people with HIV and PrEP methods among those without HIV, as well as to examine the correlations and reasons for these preferences. Design: We conducted a cross-sectional web-based questionnaire between April and July 2021, using social media accounts of a HIV non-governmental organization. The questionnaire was open to all adults living in Argentina, irrespective of their sexual orientation or gender identity. Methods: The questionnaire included questions on substance use, depression, chronic treatment, previous experiences with injectable medication, and HIV status. Those with HIV answered questions about ART adherence and their preferences for ART methods, while those without HIV were asked about condom use, awareness of PrEP, and their preferences for PrEP methods. Results: Out of 1676 respondents, 804 had HIV, and 872 did not. Among those with HIV, 91.5% expressed a high preference for LAI-ART, with significantly higher preferences among participants with higher educational levels, cisgender gay, bisexual, and queer men, younger individuals, and those with prior injectable medication experience. Among those without HIV, 68% preferred LAI-PrEP, and this preference was positively associated with previous positive experiences with injectable medication. Conclusion: The strong preference for LAI-ART suggests the potential for improved adherence and well-being among people with HIV. Additionally, the preference for LAI-PrEP among those without HIV emphasizes the importance of considering this option for HIV prevention strategies. This study highlights the need to offer diverse methods for ART and prevention to accommodate different preferences and improve health care outcomes in Latin America.

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.

Mental health, substance use, experiences of violence, and access to health care among transgender and non-binary people during the COVID-19 lockdown in Argentina.

Background: Lockdown measures are effective to control COVID-19 spread; however, concerns have increased regarding its impact on transgender and non-binary people. Aims: This study describes self-reported changes in mental health, substance use, experiences of violence, and access to health care and basic services among transgender and non-binary population from Argentina after two months of implementation of the lockdown. Methods: An online national survey was responded by 182 participants (72 transfeminine [TF], 66 transmasculine [TM], 44 non-binary [NB] people) between May and June 2020. The questionnaire was informed by the results of focus groups, reviewed by activists, and disseminated through social media. Descriptive statistics were used to summarize data. Results: The COVID-19 pandemic and the lockdown have had a general negative impact on the participants. TF participants reported a greater proportion of negative changes in the socioeconomic aspect, such as reduction in income and barriers to access basic services (housing, food, hygiene products and financial assistance). TM and NB participants reported higher proportions of adverse psychological impact, with high frequencies of intense negative emotions and suicidal ideation. A general reduction in substance use was observed in the three groups. The most frequent source of violence in the three groups was from a family member, especially among NB participants. Half of the TF and TM individuals reported difficulties to access or continue their hormone therapy. TM and NB participants reported considerable barriers to access mental health care. Conclusion: The COVID-19 pandemic and the prolonged lockdown have had a negative impact on the transgender and NB population, aggravating their preexisting situation of vulnerability and exclusion. Furthermore, this impact affected each subgroup differently in a particular and specific way.

Obstáculos identificados por las personas trans en la accesibilidad a los consultorios inclusivos en la provincia de Buenos Aires / Barriers to access inclusive healthcare services identified by transgender people in Buenos Aires province

RESUMEN INTRODUCCIÓN El acceso a la salud para las personas trans ha sido históricamente obstaculizado por el estigma y la discriminación institucional. A pesar de los avances legales y sociales en materia de reconocimiento de derechos de los últimos años, todavía se identifican barreras para su efectivo cumplimiento. Este trabajo tuvo como objetivo describir las principales barreras en la accesibilidad a los consultorios inclusivos (CI) y analizar las necesidades específicas de la población trans que se atiende en la provincia de Buenos Aires (PBA). MÉTODOS Se presenta un subanálisis de un estudio cualitativo más amplio realizado en 2017, cuyo objetivo fue relevar información sobre demandas sanitarias, accesibilidad y calidad de atención de los servicios de salud específicos para población de lesbianas, gays, bisexuales y trans (LGBT) en ocho efectores de la PBA. La muestra fue intencional, conformada por 29 entrevistas semiestructuradas a referentes y profesionales y 2 grupos focales con masculinidades y feminidades trans, respectivamente. Se realizó un análisis temático. RESULTADOS Se identificaron barreras organizacionales y simbólicas, sobre todo en los CI que funcionan en hospitales. Entre las simbólicas, se evidencia la persistencia de prácticas patologizantes en salud mental. DISCUSIÓN Los CI brindan una respuesta satisfactoria, pero transitoria. Es necesario transversalizar la perspectiva de género a todas las intervenciones en salud.

ABSTRACT INTRODUCTION Access to health for trans people has historically been hampered by institutional stigma and discrimination. Despite the legal and social advances achieved in recent years in terms of recognition of rights, barriers to effective enforcement are still identified. The objective of this work was to describe the main barriers to access inclusive healthcare services and analyze the specific needs of trans people receiving healthcare in the province of Buenos Aires (PBA). METHODS A subanalysis of a wider qualitative study conducted in 2017 is presented, its objective was to collect information on healthcare needs, accessibility and quality of care of health services specific for lesbian, gay, bisexual and transgender (LGBT) population in eight healthcare providers of PBA. The sample was intentional, including 29 semi-structured interviews to social organization leaders and professionals, and 2 focus groups with trans masculinities and femininities, respectively. Data were analyzed using thematic analysis. RESULTS Organizational and symbolic barriers were identified, especially in inclusive healthcare services functioning in hospitals. One of the symbolic ones was the persistence of pathologizing practices in mental healthcare. DISCUSSION Inclusive healthcare services provide a satisfactory, but temporary response. It is necessary to adopt a cross-cutting gender perspective for all healthcare interventions.

Retention among transgender women treated with dolutegravir associated with tenofovir/lamivudine or emtricitabine in Argentina: TransViiV study.

In Argentina, transgender women (TGW) have a high HIV prevalence (34%). However, this population shows lower levels of adherence, retention in HIV care and viral suppression than cisgender patients. The World Health Organization (WHO) recommends the transition to dolutegravir (DTG)-based regimens to reduce adverse events and improve adherence and retention. The purpose of this study was to determine retention, adherence and viral suppression in naïve TGW starting a DTG-based first-line antiretroviral treatment (ART) and to identify clinical and psychosocial factors associated with retention. We designed a prospective, open-label, single-arm trial among ART-naïve HIV positive TGW (Clinical Trial Number: NCT03033836). Participants were followed at weeks 4, 8, 12, 24, 36 and 48, in a trans-affirmative HIV care service that included peer navigators, between December, 2015 and May, 2019. Retention was defined as the proportion of TGW retained at week 48 and adherence was self-reported. Viral suppression at <50 copies/mL was evaluated using snapshot algorithm and as per protocol analysis. Of 75 TGW screened, 61 were enrolled. At baseline, median age was 28 y/o., HIV-1-RNA (pVL) 46,908 copies/mL and CD4+ T-cell count 383 cells/mm3. At week 48, 77% were retained and 72% had viral suppression (97% per protocol). The regimen was well tolerated and participants reported high adherence (about 95%). Eleven of the fourteen TGW who discontinued or were lost to follow-up had undetectable pVL at their last visit. Older age was associated with better retention. DTG-based treatment delivered by a trans-competent team in a trans-affirmative service was safe and well tolerated by TGW and associated with high retention, high adherence and high viral suppression at 48 weeks among those being retained.

"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.

Design and Development of an Electronic Health Record According to Argentine Gender Identity Law.

Health information systems face the challenge of collecting data on patients' gender identity. The absence of this information may lead the patients to situations of vulnerability and discrimination. The objective of this study is to describe the process of designing and developing an Electronic Health Record according to the Argentine Gender Identity Law. This health record allows clinics to record legal names and surnames, other social names, gender identity, sex at birth, and legal sex.

Examining Factors Associated with Gender Identity Among Individuals Disengaged from HIV Care in Argentina.

BACKGROUND: Transgender women (TGW) consistently show lower adherence to antiretroviral treatment (ART), than cisgender people (CP) living with HIV. This study examined sociodemographic and psychosocial factors associated with gender identity among individuals disengaged from HIV care in Argentina. METHODS: Data for this study was obtained at baseline from the Conexiones y Opciones Positivas en la Argentina 2 (COPA2) study. Forty-one TGW and 360 CP (177 male, 183 female) disengaged from HIV care completed questionnaires assessing sociodemographic information, severity of depressive symptoms, substance and alcohol use, patient-provider relationship quality, self-efficacy, ART adherence motivation, self-reported adherence, and treatment-related factors. Analyses included chi-square tests exploring the association between categorical variables and gender identity, and ANCOVAs comparing groups controlling for age. RESULTS: Being a TGW was associated with having only public health insurance; substance use, particularly cocaine; substance-related problems; and hazardous drinking. TGW showed more negative consequences related to substance use, more hazardous alcohol use, lower patient-provider relationship quality, and lower self-reported adherence, than CP. CONCLUSIONS: Harm reduction should be a key component in HIV care for TGW to address substance use. Health care teams should receive formal training in patient-provider communication skills and trans-specific competencies to enhance TGW's adherence and retention. Public policies to address structural factors that negatively affect TGW's adherence to ART are also needed.

Cumplimiento y satisfacción con el aislamiento durante la pandemia de COVID-19 en Argentina y exploración de su impacto psicológico / Compliance and satisfaction with lockdown during the COVID-19 pandemic in Argentina and exploration of its psychological impact ISSN 2718-7845. Actualizaciones en sida e infectología. Buenos Aires. julio 2021. volumen 29. número 106: 72-84 Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0Internacionalhttps://creativecommons.org/licenses/by-nc/4.0/i

Como respuesta a la propagación de la pandemia de COVID-19, Argentina implementó el aislamiento social, preventivo y obligatorio (ASPO). Este estudio analizó factores asociados con el cumplimiento y la satisfacción con el ASPO a 30 días de su implementación en Argentina e indagó en las respuestas emocionales autoinformadas a esta medida. Una encuesta en línea, diseñada ad hoc, fue respondida por 2965 participantes de los 24 distritos del país entre el 18 y el 21 de abril de 2020. El 68,4% (n = 2021) eran de género femenino y el 31,6% (n = 935) masculino. La media de edad fue 43,49 años (DE = 14,97). Se realizaron pruebas de chi-cuadrado y análisis de regresión logística para explorar asociaciones entre diferentes variables y los niveles de cumplimiento y satisfacción. Las respuestas emocionales se analizaron cualitativamente. Pertenecer a un grupo en riesgo para COVID-19, haber experimentado una reducción en los ingresos del hogar y una mayor satisfacción con el ASPO se asociaron con mayores probabilidades de cumplimiento total. La menor satisfacción se asoció con ser de género masculino, pertenecer a un grupo en riesgo para COVID-19, priorizar la economía tanto como (o más que) la salud, y haber experimentado una reducción en los ingresos del hogar. Las respuestas emocionales reportadas con mayor frecuencia estuvieron relacionadas con la ansiedad y el afecto negativo o deprimido, aunque también se mencionaron estrategias de afrontamiento y emociones positivas. Estos resultados contribuyen a generar recomendaciones para mejorar la efectividad en la implementación de estas medidas para el control de la pandemia de COVID-19

In response to the spread of the COVID-19 pandemic, Argentina implemented social, preventive, and mandatory lockdown (SPML). This study analyzed factors associated with compliance and satisfaction with the SPML 30 days after its implementation in Argentina and self-reported emotional responses to this measure. An online survey, designed ad hoc, was answered by 2,965 participants from the 24 districts of the country between April 18 and 21, 2020. From them, 68.4% (n = 2021) were female and 31.6% (n = 935) were male. The mean age was 43.49 years (SD = 14.97). Chi-square tests and logistic regression analysis were performed to explore associations between different variables and levels of compliance and satisfaction. Emotional responses were qualitatively analyzed. Belonging to a group at risk for COVID-19, having experienced a reduction in household income, and greater satisfaction with the SPML were associated with higher odds of total compliance. Lower satisfaction was associated with being male, belonging to a group at risk for COVID-19, prioritizing economy as much as (or more than) health, and having experienced a reduction in household income. The most frequently reported emotional responses were related to anxiety and negative or depressed affect, although coping strategies and positive emotions were also mentioned. These results contribute to generating recommendations to improve the effectiveness of the implementation of these measures for the control of the COVID-19 pandemic.

Acceptability of dual HIV/syphilis rapid test in community- and home-based testing strategy among transgender women in Buenos Aires, Argentina.

BACKGROUND: Little is known of acceptability and feasibility of dual HIV and syphilis rapid tests in community- and home-based provider-initiated strategies among transgender women (TGW), in Latin America. Objectives were (1) to assess the acceptability of this strategy and, (2) to determine the percentage of positive results of HIV and syphilis, analyze the correlates of HIV or syphilis positive results, and measure the rates of effective referral and treatment completion among TGW. METHODS: A multidisciplinary team tested 89 TGW in Buenos Aires. An acceptability survey was administered after the HIV/syphilis Duo test was used. All confirmed cases were referred for treatment initiation. RESULTS: We found high levels of acceptability (98.8%) of this strategy among TGW. However, only 60.7% preferred simultaneous HIV and syphilis diagnosis test. Moreover, we found 9% of positive results of HIV, 51.7% of syphilis, and 3.4% of positive results for both infections. Only not being tested before was associated with an HIV positive result, and only low level of education was associated with a positive syphilis result. Among 8 TGW who tested positive for HIV, 37.5% (n = 3) started antiretroviral therapy. Of 46 who tested positive for syphilis, only 73.9% (n = 34) were effectively referred and from 23 who started treatment, only 39.1% completed it. CONCLUSIONS: Community- and home-based dual HIV and syphilis rapid test is a feasible and highly acceptable approach for this hard-to-reach population. Implementing similar strategies could improve screening uptake and accessibility. However, these results highlight the need to improve strategies for treatment uptake, in order to reduce morbidity and risk of onward transmission.

Ethics and the treatment as prevention strategy among transgender women living with HIV in Argentina.

While numerous ethical concerns have been voiced regarding HIV service scale-up strategies targeting key populations, few studies have examined these from the perspective of affected groups. This study therefore sought to understand transgender women's experiences and perspectives of targeted HIV services scale-up in the context of Argentina's Treatment as Prevention strategy. In 2016, 25 purposively selected transgender women living with HIV were interviewed by a peer research associate. Interviews were audio recorded, transcribed verbatim and analysed using participatory coding techniques. Findings suggest that procedures around informed consent, including the provision of full information in lay language and voluntariness, were lacking both pre- and post-HIV test. Further, many transgender women felt disrespected and disregarded by healthcare workers. While the majority of participants were unaware of Treatment as Prevention, once explained, most felt the approach was ethical overall, and helped improve equity in HIV service access. Study findings offer several community-driven suggestions to support patient rights and the ethical scale-up of HIV services for transgender women in Buenos Aires, including the need for training in and the provision of non-judgemental, gender-affirmative care and the inclusion of peer-navigators.

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"

Factores psicosociales asociados a la adquisición de ITS en jóvenes gays, bisexuales y otros hombres que tienen sexo con hombres del AMBA / Psychosocial factors associated with the acquisition of STIs in young gays, bisexuals and other men who have sex with men from the AMBA

INTRODUCCIÓN Los hombres gays, bisexuales y hombres que tienen sexo con hombres (HGByHSH) especialmente los jóvenes, continúan presentando prevalencias de infecciones de transmisión sexua (ITS) elevadas en Argentina. Desde la perspectiva de los determinantes sociales de la salud, sdestaca la importancia de investigar los factores psicosociales (salud mental, consumo d sustancias, experiencias de homofobia). OBJETIVOS Describir la situación de salud sexual y menta en adolescentes y jóvenes HGByHSH residentes en el Área Metropolitana de Buenos Aires, determinar los correlatos psicosociales y sociodemográficos de conductas sexuales sin preservativo y adquisición de ITS. MÉTODOS Se enrolaron 150 jóvenes HGByHSH entre 18 y 30 años. Se realizó un estudio longitudinal. En la vista basal se realizó testeo rápido de VIH y sífilis, screening de gonorrea, clamidia y hepatitis, y una entrevista psicosocial para relevar información sociodemográfica, comportamiento sexual, salud mental, consumo de sustancias, y experiencias de homofobia y violencia. RESULTADOS La ITS con mayor prevalencia fue la sífilis (15,5%). Más de la mitad reportó haber tenido sexo anal sin preservativo con al menos una pareja en el último me(54,5% receptivas y 52,4% insertivas). El 60,8% exhibió síntomas depresivos significativos y 30,7%, ideación suicida en la última semana. El 76,9% usó alguna sustancia antes o durante la relaciones sexuales en los últimos 3 meses. Los principales correlatos de sexo anal sin preservativo fueron para las receptivas, violencia verbal por parte de miembros de la familia, y uso de sustancia antes o durante las relaciones sexuales; para las insertivas, hacer trabajo sexual, ser migrante violencia verbal y sexual por parte de la familia. DISCUSIÓN Se requieren intervenciones preventivas en salud sexual dirigidas a jóvenes HGByHSH desde un enfoque interseccional y que contemplen componentes de reducción de daños y atención de salud mental.

Home-based HIV testing: Using different strategies among transgender women in Argentina.

BACKGROUND: In Argentina, HIV prevalence among transgender women (TGW) has been reported at 34%. The stigma is one of the most important factors limiting their access to healthcare services. The aims of this study were to compare different HIV testing methodologies, to determine the factors associated with HIV diagnosis and to determine the feasibility of a home-based HIV testing service for TGW. METHODS: A multidisciplinary team performed home-based HIV testing interventions in four cities of Argentina. Participants self-identified as TGW, older than 14 years and with a negative or unknown HIV status. Blood samples were screened by two rapid tests (RT), one based on antibodies (Determine™ HIV-1/2) and the other on antigen and antibodies (Determine™ HIV-1/2 Combo), and the subsequent blood processing via 4th generation ELISA (VIDAS HIV DUO). All reactive samples were confirmed with a viral load (VL). We compared the results of both RT with the ELISA. Samples were pooled in groups of 6 and a VL (Abbott Real Time) performed to identify acute HIV infections. Factors associated with HIV infection were evaluated with multivariate logistic regression analysis. RESULTS: A total of 260 TGW were tested, 51 tested positive (HIV prevalence 19.6%). There were no discordant results between both RTs nor between RTs and 4th generation ELISA, therefore the correlation was 100%. The VL identified 2 additional positive samples. The final analytic sample for positive cases consisted of 53 TGW. In the multivariate analysis, factors associated with a positive HIV result were history of other sexually transmitted infections (STIs) and not being previously tested for HIV. TGW tested for the first time were at 4 times greater risk of being HIV positive compared to those that were tested previously. CONCLUSIONS: A multidisciplinary home-based HIV testing service among TGW is feasible and effective to detect cases of HIV infection. The testing algorithm should start with an RT followed by molecular diagnosis. The history of STIs and never having been tested for HIV were the factors associated with HIV-positive results and should determine efforts to reach this population. Home-based testing reaches individuals that were not tested before and who have more risk of acquiring HIV.

Reduction of Gender Identity Stigma and Improvements in Mental Health Among Transgender Women Initiating HIV Treatment in a Trans-Sensitive Clinic in Argentina.

Purpose: 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. Methods: 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 t-tests, to explore changes between baseline and 6 months. Results: 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. Conclusion: 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.

Do Transgender People Respond According to Their Biological Sex or Their Gender Identity When Confronted With Romantic Rivals?

This study examined the hypothesis that gender identity and biological sex represent independent modules and that transgender individuals respond to romantic rivals in line with their gender identity and not with their biological sex. Additionally, associations of jealousy with intrasexual competitiveness (ISC) and social comparison orientation (SCO) were explored. A total of 134 male-to-female and 94 female-to-male transgender individuals from Greater Buenos Aires, Argentina, responded to a questionnaire. In line with the predictions, female-to-male transgender individuals experienced more jealousy than male-to-female transgender individuals in response to a physically dominant rival, whereas male-to-female individuals experienced more jealousy than female-to-male individuals in response to a physically attractive rival. Regardless of their gender identity, in both groups social-communal attributes were the most jealousy-evoking characteristic. Overall, the results indicate that transgender individuals mainly respond in line with their gender identity and not in line with their biological sex when facing romantic rivals. In addition, transgender individuals high in ISC experienced relatively more jealousy in response to all rival characteristics, whereas SCO was only among male-to-female individuals associated with jealousy.

Factores contextuales, sociales e individuales como barreras y facilitadores para el acceso a la salud de mujeres trans: desde la perspectiva de la comunidad / Contextual, social and individual factors as barriers and facilitators for healthcare access of trans women: a community perspective

Introducción: Las mujeres transgénero (MT) son vulnerables a diversos problemas de salud, incluyendo el virus de la inmunodeficiencia humana (VIH) y otras infecciones de transmisión sexual (ITS), que reducen significativamente su expectativa de vida. Consecuentemente, existe la necesidad de entender los factores que afectan su acceso a la salud.Métodos: Se realizó una investigación cualitativa en MT que viven en alojamientos comunitarios (HT, hoteles trans) en Buenos Aires. El objetivo del estudio fue explorar las barreras y facilitadores contextuales, sociales e individuales para el acceso a la salud, particularmente los servicios de VIH, y la aceptabilidad de diferentes intervenciones. Se realizaron dos grupos focales y cinco entrevistas en tres hoteles trans.Resultados: Las barreras contextuales descriptas fueron los turnos limitados y las largas horas de espera. Los obstáculos sociales incluyeron el estigma y la discriminación por parte del personal y la culpabilización de las MT de sus problemas de salud, así como el estigma por VIH dentro de los grupos de MT. El facilitador más importante fueron los servicios inclusivos. Las barreras individuales incluyeron la auto-exclusión y el estigma anticipado, resultando en altos índices de automedicación e inyección de siliconas. Las pares juegan un rol importante acompañando a otras MT a los servicios. Aun reportando problemas similares, las MT recomendaron intervenciones diferentes según su perfil de hotel. Conclusiones: Dado que el estigma y la discriminación son la principal barrera, es imprescindible sensibilizar a todo el personal de salud. Se necesita implementar una amplia gama de estrategias en los establecimientos de salud y evaluar la aceptación de intervenciones domiciliarias para responder a las diferentes demandas de las MT

Background: Transgender women (TGW) are vulnerable to several health problems, including HIV and other STDs, which significantly reduces their life expectancy. Therefore, there is an urgent need to understand factors affecting access to healthcare.Methods: A qualitative study was conducted among TGW living in rooming houses (TRH) in Buenos Aires. The objective of the study was to explore contextual, social and individual barriers and facilitators to access healthcare, particularly HIV services, and the acceptability of interventions. Two focus groups and five interviews were conducted in three TRH.Results: Contextual barriers described were the limited number of appointments and long waiting hours. Social obstacles included health workers' stigma and discrimination and blaming of TGW for their health burdens, as well as HIV stigma within TGW groups. Most important facilitator were inclusive services. Individual barriers were self-exclusion and anticipated stigma, resulting in high rates of self-medication and industrial silicone injection. Peers play an important role by accompanying others TGW to healthcare. While reporting similar problems, TGW recommended different interventions according to their THR profile. Conclusions: As the stigma and discrimination is the most important barrier, it is imperative to ensure awareness of transgender issues for all personnel of healthcare services. It is necessary to implement a wide range of strategies in health facilities, and evaluate the community acceptance of domiciliary interventions, in order to respond to the different demands of this population

Resources to cope with stigma related to HIV status, gender identity, and sexual orientation in gay men and transgender women.

The stigma related to HIV status, gender identity, and sexual orientation has negative implications for the quality of life of individuals. A qualitative study was conducted to explore the resources that these stigmatized groups recognize as tools to cope with stigma and maintain their psychological well-being. Four focus groups were conducted with gay men and transgender women divided by HIV status. A thematic analysis revealed that individual, interpersonal, and institutional resources are commonly recognized as coping resources. This article discusses the importance of enhancing self-acceptance, social support, and a legal framework that legitimizes these groups as right holders.

Efecto de la terapia hormonal en bienestar de personas transgénero / Effect of hormone therapy on the well-being of transgender people

Frecuentemente las personas trans demandan terapia hormonal cruzada (THC) como estrategia de afirmación de género y, consecuentemente, como forma de mejorar su bienestar. El objetivo fue evaluar el efecto de la terapia hormonal cruzada (THC) sobre la calidad de vida en salud (CVS) y el funcionamiento psicológico en hombres y mujeres trans. Asimismo, se exploró la influencia de las modificaciones corporales y del estigma por identidad de género sobre estas variables. El componente transversal incluyó 102 personas trans sin THC, 91 personas trans bajo THC y 140 personas cisgénero. El componente longitudinal evaluó 64 personas trans al inicio y a los 6 meses de THC. Los participantes realizaron controles clínicos, exámenes de laboratorio y completaron una batería psico-social. Se encontró que las personas trans sin THC tienen un menor bienestar psicológico y CVS, en el componente de salud mental, que las personas trans bajo THC y las personas cisgénero. Sin embargo, este malestar se reduce a 6 meses de iniciada la THC. Además, se encontró que el estigma por identidad de género predice la salud mental de las personas trans, pero que el mismo se reduce cuando las personas acceden a la THC. Este estudio multicéntrico brinda evidencia acerca de la relevancia de facilitar el acceso a la THC en personas trans, conforme a la Ley de Identidad de Género