Navigating HIV research among criminalized gender minority populations in Uganda: qualitative insights and lessons learned from novice researchers.

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Journal for Equity in Health Pub Date : 2024-10-07 DOI:10.1186/s12939-024-02294-1
Patience A Muwanguzi, Racheal Nabunya, Tom D Ngabirano
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Abstract

Background: Transgender individuals often face stigma, discrimination, and various forms of abuse, which negatively impact their mental and physical health. They face a significantly greater risk of HIV, with a higher prevalence than the general population. Despite these challenges, transgender people have limited access to healthcare due to violence, legal barriers, and societal stigma, further exacerbated in countries like Uganda, where transgender identities are criminalized. Therefore, this study explored the lived experiences of HIV researchers working with gender minority populations in criminalizing contexts.

Methods: This was an interpretative phenomenological analysis (IPA) qualitative study. Twelve (12) research team members at all levels were involved in the study. Participants had less than five years of involvement in HIV research among gender minority populations. Data were collected using field notes, reflective journals, documentation from daily team debriefing sessions, and semi-structured interviews. The analysis used NVivo software.

Results: Positive experiences, barriers, and challenges were captured. The positive experiences were 'respecting cultural diversity', 'expanding networks', 'addressing misconceptions' and 'finding allies'. The barriers included 'experiencing stigma', 'lengthy research processes', 'feeling isolated', 'fearing for personal safety', 'unexpected logistical costs', and 'criminalization of sexual and gender minorities'. The key themes that emerged from the lessons learned were: 'dealing with gatekeepers', 'diversity and sensitivity training', 'leveraging networks', 'meaningful community engagement', 'reflexivity', 'ensuring safety', 'equal partnership', 'giving feedback' and 'awareness of legal implications'.

Conclusions: This study highlights the importance of cultural sensitivity, community engagement, and reflexivity in research design and implementation. The findings emphasize the need for innovative strategies to navigate legal, social, and logistical barriers that researchers and participants face. Despite these challenges, the study demonstrates that meaningful collaboration with community members and building trust can significantly enhance the research process and outcomes. Future research should continue to explore these strategies while addressing ethical and safety concerns.

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在乌干达被定罪的性别少数群体中开展艾滋病研究:研究新手的定性见解和经验教训。
背景:变性人经常面临污名化、歧视和各种形式的虐待,这对他们的身心健康造成了负面影响。他们感染艾滋病毒的风险更大,发病率高于普通人群。尽管存在这些挑战,但由于暴力、法律障碍和社会污名,变性人获得医疗保健的机会有限,而在乌干达等国家,变性人身份被定为犯罪,这进一步加剧了变性人获得医疗保健的机会。因此,本研究探讨了在定罪背景下为性别少数群体工作的艾滋病研究人员的生活经历:这是一项解释性现象分析(IPA)定性研究。十二(12)名各级研究团队成员参与了这项研究。参与者参与性别少数群体艾滋病研究的时间不到五年。数据收集采用了现场笔记、反思日记、团队每日汇报会记录和半结构化访谈。分析使用了 NVivo 软件:结果:收集到了积极的经验、障碍和挑战。积极经验包括 "尊重文化多样性"、"扩大网络"、"消除误解 "和 "找到盟友"。障碍包括 "遭遇污名化"、"研究过程冗长"、"感到孤立"、"担心人身安全"、"意外的后勤成本 "以及 "性少数群体和性别少数群体被定罪"。从经验教训中总结出的关键主题包括与看门人打交道"、"多样性和敏感性培训"、"利用网络"、"有意义的社区参与"、"反思"、"确保安全"、"平等伙伴关系"、"反馈 "和 "法律意识":本研究强调了文化敏感性、社区参与和反思性在研究设计和实施中的重要性。研究结果强调,需要采取创新战略来克服研究人员和参与者面临的法律、社会和后勤障碍。尽管存在这些挑战,但本研究表明,与社区成员开展有意义的合作并建立信任,可以大大加强研究过程和成果。未来的研究应继续探索这些策略,同时解决伦理和安全问题。
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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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