Comparing Stigma and HIV Outcomes Between Transgender and Cisgender Women Sex Workers Living with HIV in the Dominican Republic.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-06-17 eCollection Date: 2024-06-01 DOI:10.1089/trgh.2022.0099

Tamar Goldenberg, Tahilin Karver, Deanna Kerrigan, Hoisex Gomez, Martha Perez, Yeycy Donastorg, Clare Barrington

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Abstract

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 t-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; p=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; p<0.001), but transgender women reported more enacted (cisgender: mean=49.99, SD=9.11; transgender: mean=59.93, SD=4.89; p<0.001) and internalized sex work stigma (cisgender: mean=50.00, SD=8.80; transgender: mean=57.84, SD=8.34; p<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%, p<0.001), be currently taking antiretroviral therapy (cisgender: 96.21%, transgender: 84.00%, p<0.001), and be virally suppressed (cisgender: 76.19%, transgender: 64.00%, p=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.

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多米尼加共和国感染艾滋病毒的跨性别和顺性别女性性工作者的耻辱和艾滋病毒结果比较

目的：利用交叉性框架，我们比较了多米尼加共和国（DR）感染 HIV 的跨性别和顺性别女性性工作者的污名化和 HIV 护理及治疗结果：2018-2019 年，我们在圣多明各（多米尼加共和国）对 211 名顺性女性和 100 名跨性别女性进行了访谈调查，收集了相关数据。我们使用 t 检验和卡方检验来研究性工作污名化、HIV 污名化以及 HIV 护理和治疗方面的差异：变性参与者报告的预期艾滋病耻辱感（平均值=13.61，标准差[SD]=2.39）高于双性恋参与者（平均值=12.96，标准差=2.21；P=0.018），但在内化或实施的艾滋病耻辱感方面没有统计学意义上的显著差异。双性恋参与者报告了更多预期的性工作污名（双性恋：平均值=50.00，标准差=9.22；变性人：平均值=44.02，标准差=9.54；ppppp=0.025）：结论：与顺性别参与者相比，跨性别参与者的艾滋病护理和治疗效果一直较差。跨性别者与顺性别者之间的污名化经历差异取决于污名化的类型。研究结果反映了性工作者中不同类型和形式的污名的交叉性。了解跨性别女性和顺性别女性的共同经历和独特经历将有助于提高艾滋病护理的参与度和病毒抑制率。

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