Universidad Peruana Cayetano Heredia

HIV prevention among transgender women in Latin America: implementation, gaps and challenges

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dc.contributor.author Silva-Santisteban Portella, Alfonso Alberto
dc.contributor.author Eng, Shirley
dc.contributor.author de la Iglesia, Gabriela
dc.contributor.author Falistocco, Carlos
dc.contributor.author Mazin, Rafael
dc.date.accessioned 2019-02-22T14:56:09Z
dc.date.available 2019-02-22T14:56:09Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5850
dc.description.abstract Introduction: Transgender women are the population most vulnerable to HIV in Latin America, with prevalence between 18 and 38%. Although the region has improved antiretroviral coverage, there is an urgent need to strengthen HIV prevention for key populations to meet regional targets set by governments. We conducted an assessment on the state of HIV prevention among transgender women in Latin America. Methods: We conducted a desk review of Global AIDS Response Progress Reports, national strategic plans, technical reports and peer-reviewed articles from 17 Latin American countries published through January 2015. The review was preceded by 12 semi-structured interviews with UNAIDS and Pan American Health Organization officers and a discussion group with transgender women regional leaders, to guide the identification of documents. We assessed access to, implementation and coverage of programmes; legal frameworks; community participation; inclusion of new strategies; and alignment with international recommendations. Results and discussion: Overall, prevention activities in the region focus on condom distribution, diagnosis of sexually transmitted infections and peer education, mostly delivered at health facilities, with limited community involvement. Argentina and Uruguay have implemented structural interventions to address social inclusion. Argentina, Brazil and Mexico have adopted early initiation of antiretroviral therapy and treatment as prevention strategies. The other countries do not have substantial tailored interventions and consider the trans population a sub-population of men who have sex with men in data collection and programme implementation. Limited coverage of services, discrimination and a deep-seated mistrust of the health system among transgender women are the main barriers to accessing HIV prevention services. Promising interventions include health services adapted to transgender women in Mexico; LGBT-friendly clinics in Argentina that incorporate community and health workers in mixed teams; task-shifting to community-based organizations; mobile HIV testing; and gender identity laws. Conclusions: Transgender women in Latin America continue to have limited access to HIV prevention services, which presents a bottleneck for reaching prevention goals and incorporating new prevention interventions. Prevention programmes should be rights-based; offer tailored, holistic interventions; and involve transgender women in their design and implementation. 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 Latin America en_US
dc.subject HIV prevention en_US
dc.subject prevention en_US
dc.subject transgender women en_US
dc.subject PrEP en_US
dc.title HIV prevention among transgender women in Latin America: implementation, gaps and challenges en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.7448/IAS.19.3.20799
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1758-2652


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