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Hentges B, Martins RS, da Silva JDRP, Hübner DPG, Leal AF, Teixeira LB, Knauth DR, Veras MADSM. Lifetime sexual violence among transgender women and travestis (TGW) in Brazil: Prevalence and associated factors. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27Suppl 1:e240013.supl.1. [PMID: 39166585 PMCID: PMC11338532 DOI: 10.1590/1980-549720240013.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 08/23/2024] Open
Abstract
OBJECTIVE To describe the prevalence, characteristics, and factors associated with sexual violence in transgender women and travestis (TGW) in Brazil. METHODS This cross-sectional study was conducted in five Brazilian cities (Campo Grande, Manaus, Porto Alegre, Salvador, and São Paulo) between 2019 and 2021. Participants were recruited using the respondent-driven sampling (RDS) technique. The outcome of interest is the self-reported experience of sexual violence throughout the respondents' lifetime. We evaluated the actions taken by victims of sexual violence and how they dealt with the experience. Logistic regression analysis was employed to examine the associations between sociodemographic and behavioral factors (such as race, income, drug use, sex work, and access to healthcare) and the outcome. RESULTS A total of 1,317 TGW were interviewed. Among them, 53% (n=698) reported experiencing sexual violence. For 64.4% (n=419) of the respondents, sexual violence occurred on more than one occasion. The majority of TGW did not seek health services (93.2%, n=648), disclose the violence (93.9%, n=653), nor seek support from family or friends (86.5%, n=601). A higher prevalence of sexual violence was associated with homelessness (adjusted prevalence ratio - aPR=1.69, 95% confidence interval - 95%CI 1.01-2.84), a history of engaging in sex work (aPR=2.04, 95%CI 1.46-2.85), self-reporting regular, bad, or very bad emotional health (aPR=1.67, 95%CI 1.28-2.19), and experiencing difficulties accessing health services in the previous year (aPR=2.78, 95%CI 1.74-4.43). CONCLUSION The high prevalence of sexual violence, analyzed together with the actions of the victims, indicates a context of high vulnerability and low institutional support. In this scenario, violence can be exacerbated, resulting in severe health consequences.
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Affiliation(s)
- Bruna Hentges
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology –Porto Alegre (RS), Brazil
| | - Rafael Steffens Martins
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology –Porto Alegre (RS), Brazil
| | | | | | - Andréa Fachel Leal
- Universidade Federal do Rio Grande do Sul, Department of Sociology – Porto Alegre (RS), Brazil
| | | | - Daniela Riva Knauth
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology –Porto Alegre (RS), Brazil
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Barr E, Marshall LJ, Collins LF, Godfrey C, St Vil N, Stockman JK, Davey DLJ, Dong K, Temkin SM, Glenshaw MT, Byrd C, Clayton JA, Goodenow MM. Centring the health of women across the HIV research continuum. Lancet HIV 2024; 11:e186-e194. [PMID: 38417977 PMCID: PMC11301651 DOI: 10.1016/s2352-3018(24)00004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 03/01/2024]
Abstract
Despite tremendous advances in HIV research, women and gender diverse people-particularly women from racial and ethnic groups under-represented in research, transgender women, and young women-remain disproportionately affected by HIV. Women and gender diverse people face unique challenges and have been under-represented in HIV research. The National Institutes of Health (NIH) is tasked to apply fundamental knowledge about the nature and behaviour of living systems to enhance health, lengthen life, and reduce disability. Rigorous exploration of-and interventions for-the individual, social, biological, structural, and environmental factors that influence HIV prevention, transmission, treatment, and cure is crucial to advance research for women, girls, and gender diverse people across the lifespan. In this Position Paper, we introduce a framework for an intersectional, equity-informed, data-driven approach to research on HIV and women and highlight selected issues for women and gender diverse people, including HIV prevention, HIV cure, ageing with HIV, substance use and misuse, violence, pregnancy, and breastfeeding or chestfeeding. This framework underlines a new HIV and Women Signature Programme from the NIH Office of AIDS Research and Office of Research on Women's Health that advances the NIH vision for women's health, in which all women receive evidence-based HIV prevention, treatment, and care across their lifespan tailored to their unique needs, circumstances, and goals. The time is now to centre the health of women, girls, and gender diverse people across the HIV research continuum.
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Affiliation(s)
- Elizabeth Barr
- Office of Research on Women's Health, National Institutes of Health, Bethesda, MD, USA.
| | - Leslie J Marshall
- Office of AIDS Research, National Institutes of Health, Bethesda, MD, USA
| | - Lauren F Collins
- Emory University School of Medicine and the Grady Ponce de Leon Center, Atlanta, GA, USA
| | - Catherine Godfrey
- Office of the Global AIDS Coordinator, Department of State, Washington, DC, USA
| | - Noelle St Vil
- University at Buffalo School of Social Work, Buffalo, NY, USA
| | - Jamila K Stockman
- University of California San Diego School of Medicine, San Diego, CA, USA
| | - Dvora L Joseph Davey
- Division of Infectious Diseases, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Department of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Krista Dong
- Ragon Institute of Mass General, MIT and Harvard, Cambridge, MA, USA; Infectious Diseases Division, Massachusetts General Hospital, Boston, MA, USA
| | - Sarah M Temkin
- Office of Research on Women's Health, National Institutes of Health, Bethesda, MD, USA
| | - Mary T Glenshaw
- Office of AIDS Research, National Institutes of Health, Bethesda, MD, USA
| | - Corette Byrd
- Office of AIDS Research, National Institutes of Health, Bethesda, MD, USA
| | - Janine A Clayton
- Office of Research on Women's Health, National Institutes of Health, Bethesda, MD, USA
| | - Maureen M Goodenow
- Office of the Director, National Institutes of Health, Bethesda, MD, USA
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