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The Where and How for Reaching Transgender Women and Men Who Have Sex with Men with HIV Prevention Services in Guatemala

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Abstract

This study aims to describe the transgender women and men who have sex with men (MSM) missed through venue-based sampling and illustrate how data on venues can be used to prioritize service delivery. Respondent-driven sampling (RDS) and time-location sampling (TLS) were used concurrently in 2010 for behavioral surveillance among MSM and transgender women in Guatemala City. RDS recruits who did not frequent venues (n = 106) were compared to TLS recruits (n = 609). TLS participants recruited at different types of venues were compared. RDS recruits who did not frequent venues were less educated, less likely to identify as gay, more likely to have concurrent partners and female sexual partners. Participants recruited at NGOs, saunas, hotels, streets and parks had more partners, were more likely to receive money for sex or have concurrent partners. Prevention programs for MSM and transgender women should characterize social venues and people that frequent them and improve service coverage through venues and social networks.

Resumen

El estudio tiene como objetivo describir la población de mujeres transgénero y hombres que tienen sexo con hombres (HSH) no alcanzada a través de muestreo por tiempo-lugar e ilustrar cómo utilizar los datos referentes a los puntos de encuentro para priorizar la prestación de servicios de prevención del VIH. En 2010 se implementaron en paralelo el muestreo dirigido por los participantes (RDS) y el muestreo de tiempo-lugar (TLS) para la vigilancia del comportamiento entre los HSH y mujeres trans en la Ciudad de Guatemala. Se compararon el comportamiento sexual y el acceso a servicios de prevención entre participantes de RDS que no frecuentaban puntos de encuentro (n = 106) y participantes de TLS (n = 609). Tambien se hizo la comparación entre los participantes de TLS reclutados en diferentes tipos de sitios. Los participantes de RDS que no frecuentaron sitios de reunión presentaron un menor nivel educativo, una menor probabilidad de identificarse como gay y ser más propensos a tener parejas concurrentes y parejas sexuales femeninas. Los participantes reclutados en las ONG, las saunas, hoteles, calles y parques tenían más parejas, eran más propensos a recibir dinero por sexo o tener parejas concurrentes. Los programas de prevención para los HSH y mujeres trans deben caracterizar los sitios de encuentro y a las personas que los frecuentan y mejorar la cobertura de los servicios a través de los sitios y redes sociales.

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Acknowledgements

The authors thank institutions and venue owners involved in the conduct of this study. The authors recognize the contribution of the field staff and technical consultants: Berta Alvarez, Nelson Arambu, Flor de Maria Hernandez, Jose Manuel Aguilar, Sabrina Boyce, Andres Alvarado, Sonia Morales Miranda, Jessica España, Norma Zuniga and Cesar Galindo.

Funding

This study was carried out in collaboration with Tephinet Inc. and the HIV Unit of the Center of Health Studies from the Universidad del Valle de Guatemala and supported by the Presidential Emergency Plan for AIDS relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC), under the terms of Cooperative Agreements SD43GH000014-05 and GH0000575. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    William M. Miller, William C. Miller, Sharon S. Weir, Michael E. Emch & Audrey E. Pettifor

  2. Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    William C. Miller

  3. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Clare Barrington

  4. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Clare Barrington, Sharon S. Weir, Michael E. Emch & Audrey E. Pettifor

  5. Division of Global HIV/AIDS, Centers for Disease Control and Prevention – Central America Regional Office, Guatemala City, Guatemala

    Sanny Y. Chen

  6. Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Michael E. Emch

  7. Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) Central American Office, Guatemala City, Guatemala

    Gabriela Paz-Bailey

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  1. William M. Miller
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Correspondence to William M. Miller.

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All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Miller, W.M., Miller, W.C., Barrington, C. et al. The Where and How for Reaching Transgender Women and Men Who Have Sex with Men with HIV Prevention Services in Guatemala. AIDS Behav 21, 3279–3286 (2017). https://doi.org/10.1007/s10461-016-1655-8

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  • DOI: https://doi.org/10.1007/s10461-016-1655-8

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