RESUMO
Transgender women of color (TWOC) experience high rates of police violence and victimization compared to other sexual and gender minority groups, as well as compared to other White transgender and cisgender women. While past studies have demonstrated how frequent police harassment is associated with higher psychological distress, the effect of neighborhood safety and neighborhood police violence on TWOC's mental health is rarely studied. In this study, we examine the association between neighborhood safety and neighborhood police violence with psychological distress among TWOC. Baseline self-reported data are from the TURNNT ("Trying to Understand Relationships, Networks and Neighborhoods among Transgender Woman of Color") Cohort Study (analytic n = 303). Recruitment for the study began September 2020 and ended November 2022. Eligibility criteria included being a TWOC, age 18-55, English- or Spanish-speaking, and planning to reside in the New York City metropolitan area for at least 1 year. In multivariable analyses, neighborhood safety and neighborhood police violence were associated with psychological distress. For example, individuals who reported medium levels of neighborhood police violence had 1.15 [1.03, 1.28] times the odds of experiencing psychological distress compared to those who experienced low levels of neighborhood police violence. Our data suggest that neighborhood safety and neighborhood police violence were associated with increased psychological distress among TWOC. Policies and programs to address neighborhood police violence (such as body cameras and legal consequences for abusive officers) may improve mental health among TWOC.
Assuntos
Polícia , Angústia Psicológica , Características de Residência , Segurança , Pessoas Transgênero , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Estudos de Coortes , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Cidade de Nova Iorque/epidemiologia , Polícia/psicologia , Polícia/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos , Violência/etnologia , Violência/psicologia , Violência/estatística & dados numéricos , EtnicidadeRESUMO
INTRODUCTION: In the USA, transgender women are among the most vulnerable to HIV. In particular, transgender women of colour face high rates of infection and low uptake of important HIV prevention tools, including pre-exposure prophylaxis (PrEP). This paper describes the design, sampling methods, data collection and analyses of the TURNNT ('Trying to Understand Relationships, Networks and Neighbourhoods among Transgender women of colour') study. In collaboration with communities of transgender women of colour, TURNNT aims to explore the complex social and environmental (ie, neighbourhood) structures that affect HIV prevention and other aspects of health in order to identify avenues for intervention. METHODS AND ANALYSES: TURNNT is a prospective cohort study, which will recruit 300 transgender women of colour (150 Black/African American, 100 Latina and 50 Asian/Pacific Islander participants) in New York City. There will be three waves of data collection separated by 6 months. At each wave, participants will provide information on their relationships, social and sexual networks, and neighbourhoods. Global position system technology will be used to generate individual daily path areas in order to estimate neighbourhood-level exposures. Multivariate analyses will be conducted to assess cross-sectional and longitudinal, independent and synergistic associations of personal relationships (notably individual social capital), social and sexual networks, and neighbourhood factors (notably neighbourhood-level social cohesion) with PrEP uptake and discontinuation. ETHICS AND DISSEMINATION: The TURNNT protocol was approved by the Columbia University Institutional Review Board (reference no. AAAS8164). This study will provide novel insights into the relationship, network and neighbourhood factors that influence HIV prevention behaviours among transgender women of colour and facilitate exploration of this population's health and well-being more broadly. Through community-based dissemination events and consultation with policy makers, this foundational work will be used to guide the development and implementation of future interventions with and for transgender women of colour.
Assuntos
Infecções por HIV/prevenção & controle , Soronegatividade para HIV , Relações Interpessoais , Características de Residência , Rede Social , Pessoas Transgênero , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Asiático/estatística & dados numéricos , Povo Asiático/estatística & dados numéricos , Estudos Transversais , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Cidade de Nova Iorque/etnologia , Estudos Prospectivos , Parceiros Sexuais , Pessoas Transgênero/estatística & dados numéricos , Adulto JovemRESUMO
Platelet-associated complications including thrombosis, thrombocytopenia, and hemorrhage are commonly observed during various inflammatory diseases such as sepsis, inflammatory bowel disease, and psoriasis. Despite the reported evidence on numerous mechanisms/molecules that may contribute to the dysfunction of platelets, the primary mechanisms that underpin platelet-associated complications during inflammatory diseases are not fully established. Here, we report the discovery of formyl peptide receptor 2, FPR2/ALX, in platelets and its primary role in the development of platelet-associated complications via ligation with its ligand, LL37. LL37 acts as a powerful endogenous antimicrobial peptide, but it also regulates innate immune responses. We demonstrate the impact of LL37 in the modulation of platelet reactivity, hemostasis, and thrombosis. LL37 activates a range of platelet functions, enhances thrombus formation, and shortens the tail bleeding time in mice. By utilizing a pharmacological inhibitor and Fpr2/3 (an ortholog of human FPR2/ALX)-deficient mice, the functional dependence of LL37 on FPR2/ALX was determined. Because the level of LL37 is increased in numerous inflammatory diseases, these results point toward a critical role for LL37 and FPR2/ALX in the development of platelet-related complications in such diseases. Hence, a better understanding of the clinical relevance of LL37 and FPR2/ALX in diverse pathophysiological settings will pave the way for the development of improved therapeutic strategies for a range of thromboinflammatory diseases.
Assuntos
Peptídeos Catiônicos Antimicrobianos/farmacologia , Ativação Plaquetária/efeitos dos fármacos , Peptídeos Catiônicos Antimicrobianos/química , Peptídeos Catiônicos Antimicrobianos/metabolismo , Sítios de Ligação , Plaquetas/citologia , Plaquetas/metabolismo , Cálcio/metabolismo , AMP Cíclico/metabolismo , Hemostasia/efeitos dos fármacos , Humanos , Receptores de Formil Peptídeo/química , Receptores de Formil Peptídeo/metabolismo , Receptores de Lipoxinas/química , Receptores de Lipoxinas/metabolismo , Transdução de Sinais/efeitos dos fármacos , Trombose/sangue , Trombose/etiologia , CatelicidinasRESUMO
Healing Our Women (HOW) is a group-level HIV risk-reduction intervention developed to address the role of prior sexual victimization in HIV risk and protective behaviors among HIV-positive women of color. This article describes the process of adapting HOW for transgender women of color in New York City in accordance with CDC guidance for the adaptation of efficacious interventions. Twenty-one transgender women were enrolled in a study to evaluate the acceptability and fidelity of the adapted intervention, and to assess HIV knowledge, depressive symptoms, coping, condom use self-efficacy, and condom use via pre- and post-intervention surveys. We found the adapted program to be feasible to implement and acceptable to participants. We also found significant decreases in depressive symptoms and increases in positive coping from pre- to post-intervention, although replication with a larger sample and a control group comparison is needed to determine efficacy with this population.