HIV risk and preventive interventions in transgender women sex workers

Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, a...

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Main Authors: Poteat, T., Wirtz, A., Radix, A., Borquez, A., Silva-Santisteban, A., Deutsch, M., Khan, S., Winter, Sam, Operario, D.
Format: Journal Article
Published: The Lancet Publishing Group 2015
Online Access:http://hdl.handle.net/20.500.11937/54386
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author Poteat, T.
Wirtz, A.
Radix, A.
Borquez, A.
Silva-Santisteban, A.
Deutsch, M.
Khan, S.
Winter, Sam
Operario, D.
author_facet Poteat, T.
Wirtz, A.
Radix, A.
Borquez, A.
Silva-Santisteban, A.
Deutsch, M.
Khan, S.
Winter, Sam
Operario, D.
author_sort Poteat, T.
building Curtin Institutional Repository
collection Online Access
description Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population.
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spelling curtin-20.500.11937-543862018-03-29T09:09:36Z HIV risk and preventive interventions in transgender women sex workers Poteat, T. Wirtz, A. Radix, A. Borquez, A. Silva-Santisteban, A. Deutsch, M. Khan, S. Winter, Sam Operario, D. Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. 2015 Journal Article http://hdl.handle.net/20.500.11937/54386 10.1016/S0140-6736(14)60833-3 The Lancet Publishing Group restricted
spellingShingle Poteat, T.
Wirtz, A.
Radix, A.
Borquez, A.
Silva-Santisteban, A.
Deutsch, M.
Khan, S.
Winter, Sam
Operario, D.
HIV risk and preventive interventions in transgender women sex workers
title HIV risk and preventive interventions in transgender women sex workers
title_full HIV risk and preventive interventions in transgender women sex workers
title_fullStr HIV risk and preventive interventions in transgender women sex workers
title_full_unstemmed HIV risk and preventive interventions in transgender women sex workers
title_short HIV risk and preventive interventions in transgender women sex workers
title_sort hiv risk and preventive interventions in transgender women sex workers
url http://hdl.handle.net/20.500.11937/54386