Skip to main content

Advertisement

SpringerLink
Log in

Sociocultural Contexts of Access to HIV Primary Care and Participant Experience with an Intervention Project: African American Transgender Women Living with HIV in Alameda County, California

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The baseline data of the intervention project for African American transgender women living with HIV showed that more than one-third of the participants having ever enrolled in HIV care had not received ART and that among those in ART, more than half reported their adherence to ART was poor. Those who had engaged in sex work, sold drugs, or experienced higher levels of transphobia were less likely to have enrolled in care. The qualitative interviews with participants who had completed the intervention or dropped out revealed barriers to enroll in care, such as community stigma and transphobia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Campsmith ML, Rhodes PH, Hall HI, Green TA. Undiagnosed HIV prevalence among adults and adolescents in the United States at the end of 2006. J Acquir Immune Defic Syndr. 2010;53(5):619–24.

    PubMed  Google Scholar 

  2. Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 2006;20(10):1447–50.

    PubMed  Google Scholar 

  3. Fleming P, Byers RH, Sweeney PA, Daniels D, Karon JM, Janssen RS. HIV prevalence in the United States, 2000. In: 9th conference on retroviruses and opportunistic infections. 2002; pp. 24–28.

  4. United States Department of Health and Human Services. Panel on antiretroviral guidelines for adults and adolescents. Guidelines for the Use of Antiretroviral Agents in HIV-1-infected Adults and Adolescents. https://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL003371.pdf (2013). Accessed 30 May 2018.

  5. Myers JJ, Shade SB, Rose CD, Koester K, Maiorana A, Malitz FE, Bie J, Kang-Dufour M, Morin S. Interventions delivered in clinical settings are effective in reducing risk of HIV transmission among people living with HIV: results from the Health Resources and Services Administration (HRSA)’s special projects of national significance initiative. AIDS Behav. 2010;14(3):483–92.

    PubMed  PubMed Central  Google Scholar 

  6. Marseille E, Shade SB, Myers J, Morin S. The cost-effectiveness of HIV prevention interventions for HIVinfected patients seen in clinical settings. J Acquir Immune Defic Syndr. 2011;56(3):e87–94.

    PubMed  Google Scholar 

  7. Tobias C, Cunningham WE, Cunningham CO, Pounds MB. Making the connection: the importance of engagement and retention in HIV medical care. AIDS Patient Care STDS. 2007;21(1):S3–8.

    PubMed  Google Scholar 

  8. Gardner L, Marks G, Metsch L, et al. Psychological and behavioral correlates of entering care for HIV infection: the Antiretroviral Treatment Access Study (ARTAS). AIDS Patient Care STDS. 2007;21(6):418–25.

    PubMed  Google Scholar 

  9. United States Office of National AIDS Policy. National HIV/AIDS strategy for the United States: ONAP, The White House. https://obamawhitehouse.archives.gov/sites/default/files/uploads/NHAS.pdf (2010). Accessed 30 May 2018.

  10. United States Health Resources and Services Administration (HRSA), HIV/AIDS Bureau Going the distance: the Ryan White HIV/AIDS program, 20 years of leadership, a legacy of care. Rockville, MD: U.S. Health Resources and Services Administration; 2010.

  11. Ashman JJ, Conviser R, Pounds MB. Associations between HIV-positive individuals’ receipt of ancillary services and medical care receipt and retention. AIDS Care. 2002;14(1):S109–18.

    PubMed  Google Scholar 

  12. Nemoto T, Cruz TM, Iwamoto M, Sakata M. A tale of two cities: access to care and services among African-American transgender women in Oakland and San Francisco. LGBT Health. 2015;2(3):235–42.

    PubMed  PubMed Central  Google Scholar 

  13. Xavier J, Honnold JA, Bradford JB. The health, health-related needs, and lifecourse experiences of transgender Virginians. Division of Disease Prevention through the Centers of Disease Control and Prevention, Virginia Department of Health. http://www.vdh.virginia.gov/content/uploads/sites/10/2016/01/THISFINALREPORTVol1.pdf (2007). Accessed 30 May 2018.

  14. Kenagy GP. The health and social service needs of transgender people in Philadelphia. Int J Transgend. 2005;8(2–3):49–56.

    Google Scholar 

  15. Kenagy GP, Bostwick WB. Health and social service needs of transgendered people in Chicago. Int J Transgend. 2005;8(2–3):57–66.

    Google Scholar 

  16. FTM Alliance of Los Angeles. Results of the 2003 health access survey. Los Angeles, CA. http://ftmalliance.org/images/FTM_Alliance_LA_Health_Report.doc (2004).

  17. Hartzell E, Frazer MS, Wertz L, Davis M. The state of transgender California report: results from the 2008 California Transgender Economic Health Survey. Transgender Law Center: San Francisco, CA; 2009.

  18. Sperber J, Landers S, Lawrence S. Access to health care for transgendered persons: results of a needs assessment in Boston. Int J Transgend. 2005;8(2–3):74–91.

    Google Scholar 

  19. Xavier JM, Bobbin M, Singer B, Budd E. A needs assessment of transgendered people of color living in Washington, DC. Int J Transgend. 2005;8(2–3):31–47.

    Google Scholar 

  20. Zians J. The San Diego County transgender assessment report. San Diego, CA: Family Health Centers of San Diego; 2006.

    Google Scholar 

  21. Kammerer N, Mason T, Connors M. Transgender health and social service needs in the context of HIV risk. Int J Transgend. 1999;3(1):2.

    Google Scholar 

  22. Clements-Nolle K, Wilkinson W, Kitano K, Marx R. HIV prevention and health service needs of the transgender community in San Francisco. In: Bockting W, Kirk S, editors. Transgender and HIV: risks, prevention, and care. Binghamton, NY: The Haworth Press Inc; 2001. p. 69–90.

    Google Scholar 

  23. Carson L. Physical and emotional health needs of transgender individuals living in Philadelphia: summary of key findings. Philadelphia, PA: Public Health Management Corporation; 2009.

    Google Scholar 

  24. Cambridge Cares About AIDS. Transgender care and education needs diversity (TransCEND) community needs assessment report. Cambridge, MA: Cambridge Cares About AIDS; 2006.

    Google Scholar 

  25. Alameda County Public Health Department Office of AIDS Administration OTCPC, Harder + Company Community Research. 2010 Oakland Transitional Grant Area HIV/AIDS Health Services Needs Assessment. Oakland Transitional Grant Area Collaborative Community Planning Counsil. http://www.acphd.org/media/188314/needs-assesment.pdf (2010). Accessed 30 May 2018.

  26. San Francisco Department of Public Health. QUARTERLY HIV/AIDS SURVEILLANCE REPORT, HIV/AIDS Cases Reported Through December 2010. https://www.sfdph.org/dph/files/reports/RptsHIVAIDS/qRpt122010.pdf. Accessed 28 Aug 2019.

  27. Herbst JH, Jacobs ED, Finlayson TJ, et al. Estimating HIV prevalence and risk behaviors of transgender persons in the United States: a systematic review. AIDS Behav. 2008;12(1):1–17.

    PubMed  Google Scholar 

  28. Risser JM, Shelton A, McCurdy S, et al. Sex, drugs, violence, and HIV status among male-to-female transgender persons in Houston, Texas. Int J Transgend. 2005;8(2–3):67–122.

    Google Scholar 

  29. Operario D, Nemoto T. Sexual risk behavior and substance use among a sample of Asian Pacific Islander transgendered women. AIDS Educ Prev. 2005;17(5):430–43.

    PubMed  Google Scholar 

  30. UNAIDS. Malaysia: 2010 UNGASS Country Progress Report. https://www.aidsdatahub.org/sites/default/files/documents/malaysia_2010_country_progress_report_en.pdf (2010). Accessed 30 May 2018.

  31. Reisner SL, Mimiaga MJ, Bland S, Mayer KH, Perkovich B, Safren SA. HIV risk and social networks among male-to-female transgender sex workers in Boston, Massachusetts. J Assoc Nurses AIDS Care. 2009;20(5):373–86.

    PubMed  PubMed Central  Google Scholar 

  32. Nuttbrock L, Hwahng S, Bockting W, et al. Lifetime risk factors for HIV/sexually transmitted infections among male-to-female transgender persons. J Acquir Immune Defic Syndr. 2009;52(3):417–21.

    PubMed  PubMed Central  Google Scholar 

  33. Wilson E, Garofalo R, Harris RD, et al. Transgender female youth and sex work: HIV risk and a comparison of life factors related to engagement in sex work. AIDS Behav. 2009;13(5):902–13.

    PubMed  PubMed Central  Google Scholar 

  34. Nemoto T, Iwamoto M, Morris A, Bakilana M. Racial differences in HIV risk among transgender women. Oral presentation at: 136th American Public Health Association Annual Meeting. October 27, 2008; San Diego, CA. [Abstract 178483].

  35. Nemoto T, Iwamoto M, Operario D. Racial and ethnic differences in HIV risk behaviors among transgender women in the U.S. XVII International AIDS Conference. August 3-8, 2008; Mexico City, Mexico.

  36. Nemoto T, Böedeker B, Iwamoto M, Sakata M. Practice of receptive and insertive anal sex among transgender women in relation to partner types, sociocultural factors, and background variables. AIDS Care. 2014;26(4):434–40.

    PubMed  Google Scholar 

  37. Nemoto T, Operario D, Keatley J, Han L, Soma T. HIV risk behaviors among male-to-female transgender persons of color in San Francisco. Am J Public Health. 2004;94(7):1193–9.

    PubMed  PubMed Central  Google Scholar 

  38. Nemoto T, Operario D, Keatley J, Villegas D. Social context of HIV risk behaviours among male-to-female transgenders of colour. AIDS Care. 2004;16(6):724–35.

    CAS  PubMed  Google Scholar 

  39. Nemoto T, Luke D, Mamo L, Ching A, Patria J. HIV risk behaviours among male-to-female transgenders in comparison with homosexual or bisexual males and heterosexual females. AIDS Care. 1999;11(3):297–312.

    CAS  PubMed  Google Scholar 

  40. Clements-Nolle K, Marx R, Guzman R, Katz M. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention. Am J Public Health. 2001;91(6):915–21.

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Clements-Nolle K, Guzman R, Harris SG. Sex trade in a male-to-female transgender population: psychosocial correlates of inconsistent condom use. Sexual Health. 2008;5(1):49–54.

    PubMed  Google Scholar 

  42. Operario D, Soma T, Underhill K. Sex work and HIV status among transgender women: systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2008;48(1):97–103.

    PubMed  Google Scholar 

  43. Schulden JD, Song B, Barros A, et al. Rapid HIV testing in transgender communities by community-based organizations in three cities. Public Health Rep. 2008;123(3):101–14.

    PubMed  PubMed Central  Google Scholar 

  44. Sevelius JM, Reznick OG, Hart SL, Schwarcz S. Informing interventions: the importance of contextual factors in the prediction of sexual risk behaviors among transgender women. AIDS Educ Prev. 2009;21(2):113–27.

    PubMed  PubMed Central  Google Scholar 

  45. Ramirez-Valles J, Garcia D, Campbell RT, Diaz RM, Heckathorn DD. HIV infection, sexual risk behavior, and substance use among Latino gay and bisexual men and transgender persons. Am J Public Health. 2008;98(6):1036–42.

    PubMed  PubMed Central  Google Scholar 

  46. Nemoto T, Iwamoto M, Suzuki S. Access to care and HIV risk behaviors among transgender women living with HIV in Oakland, CA. Unpublished manuscript; 2010.

  47. Miller WR, Panel C. Substance abuse and mental health services administration. TIP 35: enhancing motivation for change in substance abuse treatment: treatment improvement protocol (TIP) series 35. Rockville, MD: U.S. Department of Health and Human Services; 1999. http://adaiclearinghouse.org/downloads/TIP-35-Enhancing-Motivation-for-Change-in-Substance-Abuse-Treatment-59.pdf. Accessed 15 Mar 2019.

  48. Carey MP, Braaten LS, Maisto SA, et al. Using information, motivational enhancement, and skills training to reduce the risk of HIV infection for low-income urban women. Health Psychol. 2000;19(1):3–11.

    CAS  PubMed  Google Scholar 

  49. Yahne CE, Miller WR, Irvin-Vitela L, Tonigan JS. Magdalena Pilot Project: motivational outreach to substance abusing women street sex workers. J Subst Abuse Treat. 2002;23(1):49–53.

    PubMed  Google Scholar 

  50. Foley K, Duran B, et al. Using motivational interviewing to promote HIV testing at an American Indian substance abuse treatment facility. J Psychoactive Drugs. 2005;37(3):321–9.

    PubMed  Google Scholar 

  51. Parsons JT, Golub SA, Rosof E, Holder C. Motivational interviewing and cognitive-behavioral intervention to improve HIV medication adherence among hazardous drinkers. J Acquir Immune Defic Syndr. 2007;46(4):443–50.

    PubMed  PubMed Central  Google Scholar 

  52. Alemagno SA, Stephens RC, Stephens P, Shaffer-King P, White P. Brief motivational intervention to reduce HIV risk and to increase HIV testing among offenders under community supervision. J Correct Health Care. 2009;15(3):210–21.

    PubMed  Google Scholar 

  53. Bremner JD, Bolus R, Mayer EA. Psychometric properties of the early trauma inventory-self report. J Nerv Ment Dis. 2007;195(3):211–8.

    PubMed  PubMed Central  Google Scholar 

  54. Jefferson K, Neilands TB, Sevelius J. Transgender women of color: discrimination and depression symptoms. Ethn Inequal Health Soc Care. 2013;6(4):121–36.

    PubMed  PubMed Central  Google Scholar 

  55. Bradford J, Reisner SL, Honnold JA, Xavier J. Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study. Am J Public Health. 2013;103(10):1820–9.

    PubMed  PubMed Central  Google Scholar 

  56. Nemoto T, Bödeker B, Iwamoto M. Social support, exposure to violence and transphobia, and correlates of depression among male-to-female transgender women with a history of sex work. Am J Public Health. 2011;101(10):1980–8.

    PubMed  PubMed Central  Google Scholar 

  57. Ewing JA. Detecting alcoholism: the CAGE Questionnaire. JAMA. 1984;252(14):1905–7.

    CAS  PubMed  Google Scholar 

  58. National Institute on Drug Abuse. Seek, test, treat and retain for vulnerable populations: data harmonization measure. National Institute of Health. https://www.drugabuse.gov/research/research-data-measures-resources/data-harmonization-projects/seek-test-treat-retain/addressing-hiv-among-vulnerable-populations (2013). Accessed 30 May 2018.

  59. Knight K, Simpson DD, Hiller ML. Screening and referral for substance-abuse treatment in the criminal justice system. In: Leukefeld CG, Tims F, Farabee D, editors. Treatment of drug offenders: policies and issues. New York, NY: Springer; 2002. p. 259–72.

    Google Scholar 

  60. Galvan FH, Davis EM, Banks D, Bing EG. HIV stigma and social support among African Americans. AIDS Patient Care STDS. 2008;22(5):423–36.

    PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We would like to thank African American transgender participants in the study and community collaborators and service agencies in the San Francisco Bay Area. The study was awarded by the Health Resources and Services Administration (HRSA) (Grant Number: H97HA249700500). The interpretations and recommendations presented here do not necessarily reflect the official views of HRSA.

Author information

Authors and Affiliations

  1. Public Health Institute, 1333 Broadway, Suite P110, Oakland, CA, 94612, USA

    Tooru Nemoto, Mariko Iwamoto, Sabrina Suico, Victorine Stanislaus & Kirsten Piroth

Authors
  1. Tooru Nemoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mariko Iwamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sabrina Suico
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Victorine Stanislaus
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kirsten Piroth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tooru Nemoto.

Ethics declarations

Conflict of interest

The authors have no financial conflicts of interest to declare.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nemoto, T., Iwamoto, M., Suico, S. et al. Sociocultural Contexts of Access to HIV Primary Care and Participant Experience with an Intervention Project: African American Transgender Women Living with HIV in Alameda County, California. AIDS Behav 25 (Suppl 1), 84–95 (2021). https://doi.org/10.1007/s10461-019-02752-w

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-019-02752-w

Keywords

Search

Navigation