Universidad Peruana Cayetano Heredia

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru

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dc.contributor.author Perez-Brumer, Amaya G.
dc.contributor.author Reisner, Sari L.
dc.contributor.author McLean, Sarah A.
dc.contributor.author Silva-Santisteban Portella, Alfonso Alberto
dc.contributor.author Huerta, Leyla
dc.contributor.author Mayer, Kenneth H.
dc.contributor.author Sanchez, Jorge
dc.contributor.author Clark, Jesse L.
dc.contributor.author Mimiaga, Matthew J.
dc.contributor.author Lama, Javier R.
dc.date.accessioned 2019-01-25T15:28:04Z
dc.date.available 2019-01-25T15:28:04Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4690
dc.description.abstract INTRODUCTION: In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. METHODS: Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18-44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. RESULTS: Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). CONCLUSION: This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for individual TW in Peru. Public health strategies seeking to provide HIV prevention, treatment and care for this population will benefit from recognizing existing social capital within TW communities and incorporating its strengths within HIV prevention interventions. At the intersection of HIV vulnerabilities and collective agency, dimensions of bridging and bonding social capital emerged as resiliency strategies used by TW to access needed healthcare services in Peru. Fostering TW solidarity and peer support are key components to ensure acceptability and sustainability of HIV prevention and promotion efforts. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries Journal of the International AIDS Society
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Adolescent en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Young Adult en_US
dc.subject Focus Groups en_US
dc.subject Peru en_US
dc.subject Social Stigma en_US
dc.subject community strategies en_US
dc.subject HIV Infections/drug therapy/therapy en_US
dc.subject HIV vulnerability en_US
dc.subject resiliency en_US
dc.subject social capital en_US
dc.subject Social Capital en_US
dc.subject Transgender Persons/psychology en_US
dc.subject Transgender women en_US
dc.subject Social Marginalization en_US
dc.title Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.7448/IAS.20.1.21462
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1758-2652


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