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Duncan DT, Park SH, Dharma C, Torrats-Espinosa G, Contreras J, Scheinmann R, Watson K, Herrera C, Schneider JA, Khan M, Lim S, Trinh-Shevrin C, Radix A. Neighborhood Safety and Neighborhood Police Violence Are Associated with Psychological Distress among English- and Spanish-Speaking Transgender Women of Color in New York City: Finding from the TURNNT Cohort Study. J Urban Health 2024; 101:557-570. [PMID: 38831154 PMCID: PMC11189871 DOI: 10.1007/s11524-024-00879-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 06/05/2024]
Abstract
Transgender women of color (TWOC) experience high rates of police violence and victimization compared to other sexual and gender minority groups, as well as compared to other White transgender and cisgender women. While past studies have demonstrated how frequent police harassment is associated with higher psychological distress, the effect of neighborhood safety and neighborhood police violence on TWOC's mental health is rarely studied. In this study, we examine the association between neighborhood safety and neighborhood police violence with psychological distress among TWOC. Baseline self-reported data are from the TURNNT ("Trying to Understand Relationships, Networks and Neighborhoods among Transgender Woman of Color") Cohort Study (analytic n = 303). Recruitment for the study began September 2020 and ended November 2022. Eligibility criteria included being a TWOC, age 18-55, English- or Spanish-speaking, and planning to reside in the New York City metropolitan area for at least 1 year. In multivariable analyses, neighborhood safety and neighborhood police violence were associated with psychological distress. For example, individuals who reported medium levels of neighborhood police violence had 1.15 [1.03, 1.28] times the odds of experiencing psychological distress compared to those who experienced low levels of neighborhood police violence. Our data suggest that neighborhood safety and neighborhood police violence were associated with increased psychological distress among TWOC. Policies and programs to address neighborhood police violence (such as body cameras and legal consequences for abusive officers) may improve mental health among TWOC.
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Affiliation(s)
- Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA.
| | - Su Hyun Park
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Singapore
| | - Christoffer Dharma
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
- Department of Epidemiology, University of Toronto School of Public Health, Toronto, Canada
| | | | - Jessica Contreras
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
| | - Roberta Scheinmann
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
| | | | | | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Crown School of Social Work, University of Chicago, Chicago, IL, USA
| | - Maria Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Asa Radix
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168Th Street, Room 715, New York, NY, 10032, USA
- Callen-Lorde Community Health Center, New York, NY, USA
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Wilson EC, Baguso GN, Quintana J, Suprasert B, Arayasirikul S. Detectable viral load associated with unmet mental health and substance use needs among trans women living with HIV in San Francisco, California. BMC Womens Health 2024; 24:56. [PMID: 38254161 PMCID: PMC10802058 DOI: 10.1186/s12905-024-02885-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Substance use and mental distress are known barriers to HIV care engagement among trans women. Less is known about access and utilization of mental health and substance use care among trans women and the relationship between unmet behavioral health needs and HIV viral suppression. We examined the relationship between mental health and substance use on HIV viral load among trans women living with HIV. We also examined the relationship between mental health and substance use services needs with HIV care engagement and having a detectable viral load by comparing engagement in care cascades. METHODS Data are from a 2022 baseline assessment for an intervention with trans women living with HIV (n = 42) in San Francisco. Chi-Squared or Fisher's exact tests were conducted to determine associations between HIV viral load, mental health, and substance use. We also examine characteristics associated with each step in the HIV, mental health, and substance use care cascades. RESULTS Most participants were trans women of color (85.7%), 40 years of age or older (80.9%), with low income (88.1%), and almost half were unstably housed (47.6%). Of the 32 participants who screened positive for depression, anxiety and/or psychological distress, 56.3% were referred for mental health services in the past 12 months. Of those who were referred, 44.4% received mental health services. Of the 26 participants who screened positive for a substance use disorder, 34.6% were referred to substance use services in the past 12 months. Of those referred, 33.3% received substance use services in the past 3 months. Latina trans women had a low referral rate to meet their mental health needs (50%) and only 16.7% of African American/Black trans women who screened positive for a substance use disorder were referred for services, while trans women of other race/ethnicities had high referral and services utilization. No significant results were found between HIV viral load and screening positive for a mental health disorder. Methamphetamine use was statistically associated with having a detectable HIV viral load (p = 0.049). CONCLUSIONS We identified significant unmet mental health and substance use services needs and noted racial/ethnic disparities in the context of high HIV care engagement among trans women living with HIV. We also found that methamphetamine use was a barrier to having an undetectable viral load for trans women living with HIV. To finally end the HIV epidemic, integration of behavioral health screening, linkage, and support are needed in HIV care services for populations most impacted by HIV, especially trans women. TRIAL REGISTRATION NCT, NCT 21-34,978. Registered January 19, 2022.
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Affiliation(s)
- Erin C Wilson
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, USA.
- Department of Epidemiology & Biostatistics, University of California, San Francisco, USA.
| | - Glenda N Baguso
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, USA
| | - Jerry Quintana
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, USA
| | - Bow Suprasert
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, USA
| | - Sean Arayasirikul
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, USA
- Department of Health, Society, and Behavior, Program in Public Health, University of California, Irvine, USA
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