De ve loping a c ommunity- De ve loping a c ommunity- dr dr ive n - PowerPoint PPT Presentation

De ve loping a c ommunity- De ve loping a c ommunity- dr dr ive n r ive n r e se ar e se ar c h age nda to c h age nda to stop the synde mic s that dr stop the synde mic s that dr ive ive HIV among tr HIV among tr ans wome n ans wome n Pre se nte rs: Ya sme e n Pe rsa d a nd Za c k Ma rsha ll Pre se nte rs: Ya sme e n Pe rsa d a nd Za c k Ma rsha ll RE RE ACH T ACH T ra ns Prio ritie s Pro je c t ra ns Prio ritie s Pro je c t No ve mb e r 21, 2016 No ve mb e r 21, 2016

Ove r Ove r vie w vie w  Why is the re a n inc re a se d fo c us o n tra ns wo me n a nd HI  Why is the re a n inc re a se d fo c us o n tra ns wo me n a nd HI V? V?  T  T ra ns wo me n, HI ra ns wo me n, HI V, a nd synde mic s V, a nd synde mic s  RE  RE ACH T ACH T ra ns Prio ritie s Pro je c t ra ns Prio ritie s Pro je c t  Pre limina ry Re sults fro m Pha se I  Pre limina ry Re sults fro m Pha se I  Ne xt Ste ps  Ne xt Ste ps

T T r r ans Wome n ar ans Wome n ar e a Pr e a Pr ior ior ity ity  T  T ra nsfe minine individua ls ha ve so me o f the hig he st c o nc e ntra tio ns ra nsfe minine individua ls ha ve so me o f the hig he st c o nc e ntra tio ns o f HI o f HI V e pide mic s in the wo rld V e pide mic s in the wo rld  An inte rse c tio na l le ns hig hlig hts the inc re a se d b urde n o n ra c ia lize d  An inte rse c tio na l le ns hig hlig hts the inc re a se d b urde n o n ra c ia lize d tra ns wo me n, inc luding Afric a n Ca rib b e a n Bla c k a nd L tra ns wo me n, inc luding Afric a n Ca rib b e a n Bla c k a nd L a tina / L a tina / L a tinx a tinx tra ns wo me n tra ns wo me n  E  E me rg ing da ta c o nsiste ntly suppo rt the a sso c ia tio n o f synde mic me rg ing da ta c o nsiste ntly suppo rt the a sso c ia tio n o f synde mic c o nditio ns with HI c o nditio ns with HI V risk in tra ns po pula tio ns V risk in tra ns po pula tio ns Po te a t, T ., Sc he im, A., Xa vie r, J., Re isne r, S., & Ba ra l, S. (2016). Glo b a l e pide mio lo g y o f HI V infe c tio n a nd re la te d synde mic s a ffe c ting tra nsg e nde r pe o ple . Jo urnal o f Ac quire d I mmune De fic ie nc y S yndro me s , 72( Suppl 3), S210-S219.

T T r r ans Wome n ar ans Wome n ar e Se r e Se r iously Impac te d by HIV iously Impac te d by HIV  T  T ra ns wo me n e xpe rie nc e situa te d vulne ra b ilitie s to HI ra ns wo me n e xpe rie nc e situa te d vulne ra b ilitie s to HI V tha t c a n b e V tha t c a n b e a ttrib ute d to struc tura l, c o mmunity, ne two rk, a nd individua l fa c to rs a ttrib ute d to struc tura l, c o mmunity, ne two rk, a nd individua l fa c to rs tha t a lso influe nc e the HI tha t a lso influe nc e the HI V tre a tme nt a nd c a re c o ntinuum V tre a tme nt a nd c a re c o ntinuum  F  F unda me nta l drive rs o f HI unda me nta l drive rs o f HI V in tra ns wo me n V in tra ns wo me n  Stig ma a nd disc rimina tio n  Stig ma a nd disc rimina tio n  L  L a c k o f so c ia l a nd le g a l re c o g nitio n o f a ffirme d g e nde r a c k o f so c ia l a nd le g a l re c o g nitio n o f a ffirme d g e nde r  E  E xc lusio n fro m e mplo yme nt a nd e duc a tio na l o ppo rtunitie s xc lusio n fro m e mplo yme nt a nd e duc a tio na l o ppo rtunitie s  Ba rrie rs to he a lthc a re a c c e ss influe nc ing c o ntinuum  Ba rrie rs to he a lthc a re a c c e ss influe nc ing c o ntinuum  Stig ma a nd disc rimina tio n  Stig ma a nd disc rimina tio n  L  L a c k o f he a lthc a re pro vide r c o mpe te nt in g e nde r-a ffirming c a re a c k o f he a lthc a re pro vide r c o mpe te nt in g e nde r-a ffirming c a re V e pide mic s a mo ng tra nsg e nde r wo me n. Curre nt Opinio n in HI V and AI DS , 9 (2), 168-173. Po te a t, T ., Re isne r, S. L ., & Ra dix, A. (2014). HI

Mode ls for Mode ls for Unde r Unde r standing standing Synde mic s in the Conte xt of Synde mic s in the Conte xt of T T r r ans Wome n ans Wome n

 Multile ve l dr  Multile ve l dr ive r ive r s of HIV s of HIV r r isk among tr isk among tr ans popns ans popns Str uc tur al  Struc tura l  Struc tura l  L  L a c k o f le g a l pro te c tio ns a c k o f le g a l pro te c tio ns Community  Disc rimina to ry la ws a nd  Disc rimina to ry la ws a nd po lic ie s po lic ie s  Co mmunity  Co mmunity Ne twor k  Stigma and social exclusion  Stigma and social exclusion  Ne two rk  Ne two rk  Hig h pre va le nc e pa rtne rs  Hig h pre va le nc e pa rtne rs  Hig h risk se x wo rk e nvts  Hig h risk se x wo rk e nvts Individual  I  I ndividua l ndividua l  Ana l se x  Ana l se x Po te a t, T ., Sc he im, A., Xa vie r, J., Re isne r, S., & Ba ra l, S. (2016). Glo b a l e pide mio lo g y o f HI V infe c tio n a nd re la te d synde mic s a ffe c ting tra nsg e nde r pe o ple . Jo urnal o f Ac quire d I mmune De fic ie nc y S yndro me s , 72( Suppl 3), S210-S219.

Synde mic R Synde mic R e lationships for e lationships for T T r r ans Wome n ans Wome n Hor mone Misuse Se x Wor k Inc ar c e r ation Substanc e Use Re b a c k, C. J., & F le tc he r, J. B. (2014). HI V pre va le nc e , sub sta nc e use , a nd se xua l risk b e ha vio rs a mo ng tra nsg e nde r wo me n re c ruite d thro ug h o utre a c h. AI DS and Be havio r, 18 (7), 1359-1367.

R R E E ACH T ACH T r r ans Pr ans Pr ior ior itie s Pr itie s Pr oje c t oje c t CR CR OSS COUNT OSS COUNT R R Y T Y T R R ANS WOME ANS WOME N AND HIV R N AND HIV R E E SE SE AR AR CH PR CH PR IOR IOR IT IT Y SE Y SE T T T T ING ING

What is the R What is the R E E ACH T ACH T r r ans Pr ans Pr ior ior itie s Pr itie s Pr oje c t? oje c t?  T  T ra ns-le d na tio na l re se a rc h pro je c t c e nte ring the e xpe rie nc e s ra ns-le d na tio na l re se a rc h pro je c t c e nte ring the e xpe rie nc e s o f tra ns wo me n mo st a ffe c te d b y HI o f tra ns wo me n mo st a ffe c te d b y HI V V  Ob je c tive s:  Ob je c tive s:  E  E ng a g e in a c o mmunity-b a se d re se a rc h prio rity se tting pro c e ss fo c use d o n ng a g e in a c o mmunity-b a se d re se a rc h prio rity se tting pro c e ss fo c use d o n tra ns wo me n a ffe c te d b y HI tra ns wo me n a ffe c te d b y HI V V  Co nne c t tra ns wo me n, c o mmunitie s, a nd le a de rs in urb a n c e ntre s a c ro ss  Co nne c t tra ns wo me n, c o mmunitie s, a nd le a de rs in urb a n c e ntre s a c ro ss Ca na da Ca na da  I  I de ntify ke y prio ritie s fo r the RE de ntify ke y prio ritie s fo r the RE ACH T ACH T ra ns Re se a rc h Pro g ra m o ve r the ne xt five ra ns Re se a rc h Pro g ra m o ve r the ne xt five ye a rs ye a rs

Who ar Who ar e we ? e we ? T T he T he T ra ns Prio ritie s Pro je c t te a m is ma de ra ns Prio ritie s Pro je c t te a m is ma de up e ntire ly o f tra ns pe o ple who a re up e ntire ly o f tra ns pe o ple who a re re se a rc he rs a nd c o mmunity le a de rs with re se a rc he rs a nd c o mmunity le a de rs with e xpe rie nc e in the fie ld o f HI e xpe rie nc e in the fie ld o f HI V. V. Mo st o f us a re tra ns wo me n, with Mo st o f us a re tra ns wo me n, with e xpe rie nc e a s se x wo rke rs, fro nt-line e xpe rie nc e a s se x wo rke rs, fro nt-line c o mmunity wo rke rs, a nd HI c o mmunity wo rke rs, a nd HI V V re se a rc he rs. We a re a mix o f HI re se a rc he rs. We a re a mix o f HI V po sitive V po sitive a nd ne g a tive fo lks. a nd ne g a tive fo lks.

What have we done so far What have we done so far ? ?  I  I n spring -summe r 2016, we spo ke to 78 tra ns wo me n living with n spring -summe r 2016, we spo ke to 78 tra ns wo me n living with a nd/ o r a ffe c te d b y HI a nd/ o r a ffe c te d b y HI V thro ug h inte rvie ws a nd fo c us g ro ups in V thro ug h inte rvie ws a nd fo c us g ro ups in Va nc o uve r, E Va nc o uve r, E dmo nto n, Winnipe g , T dmo nto n, Winnipe g , T o ro nto , a nd Mo ntre a l. o ro nto , a nd Mo ntre a l.  We he ld g ro ups fo r I  We he ld g ro ups fo r I ndig e no us wo me n in Winnipe g a nd Afric a n, ndig e no us wo me n in Winnipe g a nd Afric a n, Ca rib b e a n, a nd Bla c k wo me n in T Ca rib b e a n, a nd Bla c k wo me n in T o ro nto . o ro nto .  We a ske d fo r the ir pe rspe c tive s o n e xisting se rvic e s, issue s fa c ing  We a ske d fo r the ir pe rspe c tive s o n e xisting se rvic e s, issue s fa c ing tra ns wo me n living with o r a t risk fo r HI tra ns wo me n living with o r a t risk fo r HI V, a nd po te ntia l inte rve ntio ns V, a nd po te ntia l inte rve ntio ns to impro ve tra ns wo me n’ s o utc o me s a lo ng the HI to impro ve tra ns wo me n’ s o utc o me s a lo ng the HI V pre ve ntio n a nd V pre ve ntio n a nd c a re c o ntinuum. c a re c o ntinuum.

Phase I: Conne c ting with Phase I: Conne c ting with T T r r ans Wome n ans Wome n