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
Pre se nte rs: Ya sme e n Pe rsa d a nd Za c k Ma rsha ll RE ACH T ra ns Prio ritie s Pro je c t No ve mb e r 21, 2016 Pre se nte rs: Ya sme e n Pe rsa d a nd Za c k Ma rsha ll RE ACH T ra ns Prio ritie s Pro je c t No ve mb e r 21, 2016
V?
ra ns wo me n, HI V, a nd synde mic s
ACH T ra ns Prio ritie s Pro je c t
V?
ra ns wo me n, HI V, a nd synde mic s
ACH T ra ns Prio ritie s Pro je c t
ra nsfe minine individua ls ha ve so me o f the hig he st c o nc e ntra tio ns
V e pide mic s in the wo rld
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 tinx tra ns wo me n
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 V risk in tra ns po pula tio ns
ra nsfe minine individua ls ha ve so me o f the hig he st c o nc e ntra tio ns
V e pide mic s in the wo rld
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 tinx tra ns wo me n
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 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.
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 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 V tre a tme nt a nd c a re c o ntinuum
unda me nta l drive rs o f HI V in tra ns wo me n
Stig ma a nd disc rimina tio n 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
E
xc lusio n fro m e mplo yme nt a nd e duc a tio na l o ppo rtunitie s
Stig ma a nd disc rimina tio n 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
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 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 V tre a tme nt a nd c a re c o ntinuum
unda me nta l drive rs o f HI V in tra ns wo me n
Stig ma a nd disc rimina tio n 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
E
xc lusio n fro m e mplo yme nt a nd e duc a tio na l o ppo rtunitie s
Stig ma a nd disc rimina tio n 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
Po te a t, T ., Re isne r, S. L ., & Ra dix, A. (2014). HI 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.
Str uc tur al Community Ne twor k Individual
ive r s of HIV r isk among tr ans popns
L
a c k o f le g a l pro te c tio ns
Disc rimina to ry la ws a nd
po lic ie s
Stigma and social exclusion
Hig h pre va le nc e pa rtne rs Hig h risk se x wo rk e nvts
I
ndividua l
Ana l se x
ive r s of HIV r isk among tr ans popns
L
a c k o f le g a l pro te c tio ns
Disc rimina to ry la ws a nd
po lic ie s
Stigma and social exclusion
Hig h pre va le nc e pa rtne rs Hig h risk se x wo rk e nvts
I
ndividua l
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.
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
DS and Be havio r, 18(7), 1359-1367.
CR OSS COUNT R Y T R ANS WOME N AND HIV R E SE AR CH PR IOR IT Y SE T T ING CR OSS COUNT R Y T R ANS WOME N AND HIV R E SE AR CH PR IOR IT Y SE T T ING
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 tra ns wo me n a ffe c te d b y HI 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
Ca na da
I
de ntify ke y prio ritie s fo r the RE ACH T ra ns Re se a rc h Pro g ra m o ve r the ne xt five ye a rs
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 tra ns wo me n a ffe c te d b y HI 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
Ca na da
I
de ntify ke y prio ritie s fo r the RE ACH T ra ns Re se a rc h Pro g ra m o ve r the ne xt five ye a rs
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 V thro ug h inte rvie ws a nd fo c us g ro ups in Va nc o uve r, E dmo nto n, Winnipe g , T
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
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 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 c a re c o ntinuum.
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 V thro ug h inte rvie ws a nd fo c us g ro ups in Va nc o uve r, E dmo nto n, Winnipe g , T
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
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 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 c a re c o ntinuum.
ndig e no us
a tin Ame ric a n
Asia n
ndig e no us
a tin Ame ric a n
Asia n
20 63 7 4 3
Po sitive Ne g a tive Ne ve r te ste d Do n't wa nt to sa y Didn't g o b a c k
22 75 3 Ye s No No re spo nse
78 18 4
Ye s No No re spo nse
72 21 7
Ye s No No re spo nse
a te ra l/ I ntra -c o mmunity stig ma
“T
he y’ ll te ll he r c lie nts, ‘ do n’ t g o se e he r she ’ s HI V’ o r so me thing …a nd tha t’ s why we do n’ t re a lly ta lk a b o ut it within o ur g ro ups”
“I
think, a s a tra ns pe rso n, yo u kno w, yo u're a lre a dy ma rg ina lise d. And it's [se ro po sitivity] a n e xtra la ye r o f ma rg ina lisa tio n tha t. . . me dic a lly, yo u kno w, it's no t like so me thing tha t so c ia l c ha ng e will b e e no ug h, yo u kno w, to c ha ng e tha t.”
“it is ve ry unc o mfo rta b le g o ing so me whe re tha t’ s no t spe c ific a lly g e a re d
to wa rds the m…yo u kind o f fe e l like the y’ re disc rimina ting a g a inst yo u”
a te ra l/ I ntra -c o mmunity stig ma
“T
he y’ ll te ll he r c lie nts, ‘ do n’ t g o se e he r she ’ s HI V’ o r so me thing …a nd tha t’ s why we do n’ t re a lly ta lk a b o ut it within o ur g ro ups”
“I
think, a s a tra ns pe rso n, yo u kno w, yo u're a lre a dy ma rg ina lise d. And it's [se ro po sitivity] a n e xtra la ye r o f ma rg ina lisa tio n tha t. . . me dic a lly, yo u kno w, it's no t like so me thing tha t so c ia l c ha ng e will b e e no ug h, yo u kno w, to c ha ng e tha t.”
“it is ve ry unc o mfo rta b le g o ing so me whe re tha t’ s no t spe c ific a lly g e a re d
to wa rds the m…yo u kind o f fe e l like the y’ re disc rimina ting a g a inst yo u”
V a s a tra ns wo me n’ s issue
“I also put like our media forefront like blogs, a media platform, maybe a TV station or something that really discuss with a trans face or visible trans faces, seeing that we’re not just one face, um like how can you take better care of yourself.”
“Ho using , me dic a tio n, a c c e ss to e ve rything a nd e mplo yme nt. Ca use the re
a re lo ts o f tra ns fo lks tha t g o thro ug h a ha rd time to find a jo b a nd g e tting ho using .”
V a s a tra ns wo me n’ s issue
“I also put like our media forefront like blogs, a media platform, maybe a TV station or something that really discuss with a trans face or visible trans faces, seeing that we’re not just one face, um like how can you take better care of yourself.”
“Ho using , me dic a tio n, a c c e ss to e ve rything a nd e mplo yme nt. Ca use the re
a re lo ts o f tra ns fo lks tha t g o thro ug h a ha rd time to find a jo b a nd g e tting ho using .”
nc re a se c o mpre he nsive c a re
T
ra ns wo me n pa rtic ipa ting we re mo st inte re ste d in c o mpre he nsive c a re whe re physic ia ns we re c a pa b le o f a tte nding to a ll o f the ir ne e ds, no t just fo c using o n e ithe r HI V o r tra ns issue s.
mple me nt tra ns-fo c use d a ppro a c h to pro g ra mming a nd se rvic e s
“I
think tra ns wo me n a re re se a rc he d to de a th with a b so lute ly no b e ne fit fro m
’ m no t inte re ste d in re se a rc h, I ’ m inte re ste d in se rvic e s. And ye a h. I think…tha t sho uldn’ t c o me fro m a re se a rc he r, tha t sho uld c o me fro m se x wo rke rs, tra ns se x wo rke rs tha t a re a ffe c te d b y HI V.”
e mplo yme nt
nc re a se c o mpre he nsive c a re
T
ra ns wo me n pa rtic ipa ting we re mo st inte re ste d in c o mpre he nsive c a re whe re physic ia ns we re c a pa b le o f a tte nding to a ll o f the ir ne e ds, no t just fo c using o n e ithe r HI V o r tra ns issue s.
mple me nt tra ns-fo c use d a ppro a c h to pro g ra mming a nd se rvic e s
“I
think tra ns wo me n a re re se a rc he d to de a th with a b so lute ly no b e ne fit fro m
’ m no t inte re ste d in re se a rc h, I ’ m inte re ste d in se rvic e s. And ye a h. I think…tha t sho uldn’ t c o me fro m a re se a rc he r, tha t sho uld c o me fro m se x wo rke rs, tra ns se x wo rke rs tha t a re a ffe c te d b y HI V.”
e mplo yme nt
e xte rna l e va lua tio n mo de ls ve rsus info rme d c o nse nt mo de ls)
he ra pe utic s/ surg e ry (g e nde r a ffirma tio n pro c e dure s)
ife c o urse (de ve lo pme nta l issue s, a g ing )
duc a tio n (pro vide r c ultura l c o mpe te nc y)
la c k o f po lic ie s a nd pro te c tio ns, limite d so c ia l c a pita l, g e nde r ine q uitie s)
e xte rna l e va lua tio n mo de ls ve rsus info rme d c o nse nt mo de ls)
he ra pe utic s/ surg e ry (g e nde r a ffirma tio n pro c e dure s)
ife c o urse (de ve lo pme nta l issue s, a g ing )
duc a tio n (pro vide r c ultura l c o mpe te nc y)
la c k o f po lic ie s a nd pro te c tio ns, limite d so c ia l c a pita l, g e nde r ine q uitie s)
ve y a nd 20 ke y infor mant inte r vie ws with se rvic e pro vide rs a nd re se a rc he rs in the
HI V a nd tra ns he a lth fie lds in Ca na da .
e the r e se ar c h pr ior itie s ide ntifie d b y tra ns wo me n, re se a rc he rs, a nd se rvic e
pro vide rs
e le asing c ommunity snapshots o n o ur na tio na l, c ity-
spe c ific , a nd po pula tio n-spe c ific re sults.
info rma nts, we will b e c ollabor
ating to launc h ne w r e se ar c h and inte r ve ntions.
ve y a nd 20 ke y infor mant inte r vie ws with se rvic e pro vide rs a nd re se a rc he rs in the
HI V a nd tra ns he a lth fie lds in Ca na da .
e the r e se ar c h pr ior itie s ide ntifie d b y tra ns wo me n, re se a rc he rs, a nd se rvic e
pro vide rs
e le asing c ommunity snapshots o n o ur na tio na l, c ity-
spe c ific , a nd po pula tio n-spe c ific re sults.
info rma nts, we will b e c ollabor
ating to launc h ne w r e se ar c h and inte r ve ntions.
No ra Butle r Burke Ga b rie lle L
e b la nc
Za c k Ma rsha ll E
va na Ortig o za
Ya sme e n Pe rsa d Ayde n I
. Sc he im
No ra Butle r Burke Ga b rie lle L
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Za c k Ma rsha ll E
va na Ortig o za
Ya sme e n Pe rsa d Ayde n I
. Sc he im
Jia Qing Wilso n-Ya ng Ave ry E
ve rha rt
Je mma T
Pe e r Co o rdina to rs in Winnipe g ,
Va nc o uve r, a nd E dmo nto n
F
unding
Jia Qing Wilso n-Ya ng Ave ry E
ve rha rt
Je mma T
Pe e r Co o rdina to rs in Winnipe g ,
Va nc o uve r, a nd E dmo nto n
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unding