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Souleymanov R, Amjad S, McLeod A, Payne M, Ringaert L, Larcombe L, Restall G, Brennan DJ. Impact of the COVID-19 pandemic on access to HIV testing and condom use among two-spirit, gay, bisexual, and queer (2SGBQ+) men in Manitoba. AIDS Care 2023:1-8. [PMID: 37182219 DOI: 10.1080/09540121.2023.2208324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This cross-sectional online survey (n = 347) examined the impact of the COVID-19 pandemic on access to HIV testing and condom use among Two-Spirit, gay, bisexual, and queer (2SGBQ+) men in Manitoba. Logistic regression assessed the relationship between socio-demographics and the impact of COVID-19 on access to HIV testing and condom use. Among those who answered a question on testing (n = 282), 27.7% reported reduced access to HIV testing. Among those who answered questions on condom use (n = 327), 54.4% reported decreased use of condoms. Compared to living in Winnipeg, living in a medium-sized city (Brandon) and in rural and remote areas were both associated with higher odds of reporting reduced access to HIV testing due to COVID-19. Participants who were dating (vs. married or partnered) were significantly more likely to report reduced access to HIV testing, but less likely to report decreased use of condoms, while younger age was associated with decreased use of condoms. Service providers must be prepared to respond to the impact of COVID-19 on HIV testing and condom use among younger, sexually active 2SGBQ + men, as well as those who live in small, rural, and remote areas in Manitoba.
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Affiliation(s)
- Rusty Souleymanov
- Faculty of Social Work, University of Manitoba, Winnipeg, MB, Canada
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
| | - Sana Amjad
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Albert McLeod
- Two-Spirit Consultants, Inc., Winnipeg, MB, Canada
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
| | - Michael Payne
- Nine Circles Community Health Centre, Winnipeg, MB, Canada
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
| | - Laurie Ringaert
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
| | - Linda Larcombe
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
- Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Gayle Restall
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
- Department of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - David J Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Boonyapisomparn N, Manojai N, Srikummoon P, Bunyatisai W, Traisathit P, Homkham N. Healthcare discrimination and factors associated with gender-affirming healthcare avoidance by transgender women and transgender men in Thailand: findings from a cross-sectional online-survey study. Int J Equity Health 2023; 22:31. [PMID: 36782169 PMCID: PMC9926841 DOI: 10.1186/s12939-023-01843-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Although discriminatory experiences of transgender people seeking healthcare services have been well-documented in several studies, differentiating those experiences based on gender identity/expression and related factors has been limited. The aim of this study was to compare the characteristics, experiences, attitude, and expectation toward accessing healthcare service and healthcare providers of transgender women and transgender men in Thailand. METHODS A cross-sectional study was conducted from October 2017 to March 2018. The data were collected from transgender women and transgender men aged ≥ 18 years old who lived in Thailand using online platform via different websites and Facebook pages of local transgender group. Binary logistic regression was used to identify the factors related to the study outcomes. RESULTS Of 186 transgender people who responded to the questionnaire and were eligible for the study, 73.7% (95% confidence interval [CI] = 66.7-79.8) were transgender women and 26.3% (95% CI = 20.2-33.3) were transgender men. Transgender women were more likely to seek general healthcare from non-traditional healthcare services (crude odds ratio [cOR] = 4.28; 95% CI = 1.55-11.81; P = 0.005), buy hormone treatment from non-traditional healthcare services (cOR = 3.89; 95% CI = 1.18-12.83; P = 0.026), and receive healthcare counseling from non-traditional healthcare providers (cOR = 5.16; 95% CI = 1.42-18.75; P = 0.013) than transgender men. According to the results of applying a multivariable model, transgender respondents who did not know that gender-affirming healthcare services existed in Thailand were more unwilling to receive counseling from gender-affirming healthcare providers than those who did (adjusted odds ratio = 3.70; 95% CI = 1.11-12.36; P = 0.033). CONCLUSIONS The findings from this cross-sectional study indicate that transgender women are more likely than transgender men to receive general healthcare and hormone treatment from non-traditional healthcare services and buy hormone treatment without a physician's supervision. We also found approximately 15% of transgender individuals who did not receive gender-affirming counseling services. Continuing to improve access to care for the transgender community, increasing public relations channels may encourage transgender people to access more healthcare services.
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Affiliation(s)
- Nachale Boonyapisomparn
- grid.427494.8Astraea Lesbian Foundation for Justice, New York, USA ,grid.421854.e0000 0004 1936 9529School of Business and Graduate Studies, Trinity Washington University, Washington, DC USA ,The Foundation of Transgender Alliance for Human Rights, Bangkok, Thailand
| | | | - Pimwarat Srikummoon
- grid.7132.70000 0000 9039 7662Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Walaithip Bunyatisai
- grid.7132.70000 0000 9039 7662Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Patrinee Traisathit
- grid.7132.70000 0000 9039 7662Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Research Center in Bioresources for Agriculture, Industry and Medicine, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Nontiya Homkham
- Faculty of Public Health, Thammasat University, Pathumthani, Thailand.
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Souleymanov R, Star J, McLeod A, Amjad S, Moore S, Campbell C, Lorway R, Payne M, Ringaert L, Larcombe L, Restall G, Migliardi P, Magwood B, Lachowsky NJ, Brennan DJ, Sharma UN. Relationship between sociodemographics, healthcare providers' competence and healthcare access among two-spirit, gay, bisexual, queer and other men who have sex with men in Manitoba: results from a community-based cross-sectional study. BMJ Open 2022; 12:e054596. [PMID: 35105639 PMCID: PMC8804644 DOI: 10.1136/bmjopen-2021-054596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Little is known about barriers to healthcare access for two-spirit, gay, bisexual and queer (2SGBQ+) men in Manitoba. DESIGN Data were drawn from a community-based, cross-sectional survey designed to examine health and healthcare access among 2SGBQ+ men. SETTING Community-based cross-sectional study in Manitoba, Canada. PARTICIPANTS Community-based sample of 368 2SGBQ+ men. OUTCOMES Logistic regression analyses assessed the relationship between sociodemographics, healthcare discrimination, perceived healthcare providers' 2SGBQ+ competence/knowledge and two indicators of healthcare access (analytic outcome variables): (1) having a regular healthcare provider and (2) having had a healthcare visit in the past 12 months. RESULTS In multivariate analyses, living in Brandon (adjusted OR (AOR)=0.08, 95% CI 0.03 to 0.22), small cities (AOR=0.20, 95% CI 0.04 to 0.98) and smaller towns (AOR=0.26, 95% CI 0.08 o 0.81) in Manitoba (compared with living in Winnipeg), as well as having a healthcare provider with poor (AOR=0.19, 95% CI 0.04 to 0.90) or very poor competence/knowledge (AOR=0.03, 95% CI 0.03 to 0.25) of 2SGBQ+ men's issues (compared with very good competence) was associated with lower odds of having a regular healthcare provider. Living in Brandon (AOR=0.05, 95% CI 0.02 to 0.17) and smaller towns (AOR=0.25, 95% CI 0.67 to 0.90) in Manitoba (compared with living in Winnipeg) was associated with lower odds of having a healthcare visit in the past 12 months, while identifying as a gay man compared with bisexual (AOR=12.57, 95% CI 1.88 to 83.97) was associated with higher odds of having a healthcare visit in the past 12 months. CONCLUSIONS These findings underscore the importance of reducing the gap between the healthcare access of rural and urban 2SGBQ+ men, improving healthcare providers' cultural competence and addressing their lack of knowledge of 2SGBQ+ men's issues.
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Affiliation(s)
- Rusty Souleymanov
- Faculty of Social Work, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jared Star
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Albert McLeod
- Two-Spirited People of Manitoba, Winnipeg, Manitoba, Canada
| | - Sana Amjad
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Samantha Moore
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Robert Lorway
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michael Payne
- Nine Circles Community Health Centre, Winnipeg, Manitoba, Canada
| | - Laurie Ringaert
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, Manitoba, Canada
| | - Linda Larcombe
- Department of Internal Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gayle Restall
- Department of Occupational Therapy, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Paula Migliardi
- Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | | | - Nathan J Lachowsky
- Community-Based Research Centre, Victoria, British Columbia, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - David J Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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