HIV risk and preventive interventions in transgender women sex workers

Khan, Sharful Islam; Borquez, Annick; Radix, Anita; Winter, Sam; Silva-Santisteban Portella, Alfonso Alberto; Poteat, Tonia; Wirtz, Andrea L.; Deutsch, Madeline B.; Operario, Don

dc.contributor.author	Poteat, Tonia
dc.contributor.author	Wirtz, Andrea L.
dc.contributor.author	Radix, Anita
dc.contributor.author	Borquez, Annick
dc.contributor.author	Silva-Santisteban Portella, Alfonso Alberto
dc.contributor.author	Deutsch, Madeline B.
dc.contributor.author	Khan, Sharful Islam
dc.contributor.author	Winter, Sam
dc.contributor.author	Operario, Don
dc.date.accessioned	2019-02-06T14:59:06Z
dc.date.available	2019-02-06T14:59:06Z
dc.date.issued	2015
dc.identifier.uri	https://hdl.handle.net/20.500.12866/5536
dc.description.abstract	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.	en_US
dc.language.iso	eng
dc.publisher	Elsevier
dc.relation.ispartofseries	Lancet
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.rights.uri	https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject	Female	en_US
dc.subject	Humans	en_US
dc.subject	Male	en_US
dc.subject	Social Support	en_US
dc.subject	Peru/epidemiology	en_US
dc.subject	Risk Factors	en_US
dc.subject	Health Services Accessibility	en_US
dc.subject	Condoms/statistics & numerical data	en_US
dc.subject	HIV Infections/epidemiology/prevention & control	en_US
dc.subject	Prejudice	en_US
dc.subject	San Francisco/epidemiology	en_US
dc.subject	Sex Workers/statistics & numerical data	en_US
dc.subject	Social Stigma	en_US
dc.subject	Transgender Persons/statistics & numerical data	en_US
dc.title	HIV risk and preventive interventions in transgender women sex workers	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1016/S0140-6736(14)60833-3
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.02.00
dc.relation.issn	1474-547X