Young Transgender Women of Color: Homelessness, Poverty, Childhood Sexual Abuse and Implications for HIV Care
Young Transgender Women of Color: Homelessness, Poverty, Childhood Sexual Abuse and Implications for HIV Care
复制标题
DOI：
10.1007/s10461-019-02753-9
复制
发表时间：
2019-12-21
影响因子：
4.4
通讯作者：
Birnbaum, Jeffrey M.
中科院分区：
文献类型：
--
作者：
Eastwood, Elizabeth A.;Nace, Amanda J.;Birnbaum, Jeffrey M.
本研究描述了一个年龄在18 - 24岁的感染艾滋病毒的年轻有色人种跨性别女性样本，以及她们无家可归的经历，这是由美国卫生资源和服务管理局资助的一项参与和保留艾滋病医疗护理示范项目的一部分。该研究在2012年至2017年间，让美国9个地点的有色人种跨性别女性参与到艾滋病护理中。本分析描述并比较了过去6个月内无家可归的跨性别女性和有住所的跨性别女性。我们假设无家可归会与艾滋病护理、食物、住所产生冲突，并与贫困相关。变量领域包括社会人口统计学、心理健康和药物使用、艾滋病护理、性风险行为、来自跨性别者和其他朋友的社会支持以及童年性虐待。共有102名年轻人参与研究，其中77人（75.5%）曾经无家可归，25人（24.5%）未曾无家可归。双变量分析表明，低收入、以性工作为收入来源、无力购买食物、病毒载量（VL）未得到抑制、童年遭受性虐待、社会支持水平较低以及抑郁程度较高都与无家可归有关。逻辑回归模型显示，无力购买食物（调整优势比 = 9.24，95%置信区间2.13 - 40.16）、过去6个月内病毒载量未得到抑制（调整优势比 = 0.10，95%置信区间0.02 - 0.57）以及缺乏跨性别朋友的支持（调整优势比 = 0.09，95%置信区间0.02 - 0.53）都与无家可归有关。将基本需求——食物和住所放在首位的项目或许能够让感染艾滋病毒的年轻有色人种跨性别女性参与其中，并帮助她们生存和过上更健康的生活。
This study describes a sample of HIV+ young transgender women of color aged 18-24 and their experience with homelessness as part of a demonstration project of engagement and retention in HIV medical care funded by Health Resources and Services Administration. The study engaged transgender women of color in HIV care in nine sites across the US between 2012 and 2017. This analysis describes and compares transwomen who had been homeless in the last 6 months to those not homeless. We hypothesized that homelessness would compete with HIV care, food, shelter, and be associated with poverty. Variable domains included sociodemographic, mental health and substance use, HIV care, sexual risk behavior, social support from transgender and other friends, and childhood sexual abuse. There were 102 youth enrolled, 77 (75.5%) who had been homeless, and 25 (24.5%) who had not been homeless. Bivariate analyses showed that low income, sex work as source of income, inability to afford food, lack of viral load (VL) suppression, childhood sexual abuse, lower levels of social support, and higher levels of depression were associated with homelessness. A logistic regression model showed that being unable to afford food (AOR = 9.24, 95% CI 2.13-40.16), lack of VL suppression in last 6 months (AOR = 0.10, 95% CI .02-.57), and lack of transgender friend support (AOR = 0.09, 95% CI .02-.53) was associated with homelessness. Programs that place basic needs first-food and shelter-may be able to engage and assist young transgender women of color with HIV to survive and live healthier lives.