AIDS and Behavior

, Volume 21, Issue 12, pp 3279–3286 | Cite as

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

  • William M. Miller
  • William C. Miller
  • Clare Barrington
  • Sharon S. Weir
  • Sanny Y. Chen
  • Michael E. Emch
  • Audrey E. Pettifor
  • Gabriela Paz-Bailey
Original Paper


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.


HIV MSM Surveillance HIV prevention RDS TLS 


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.



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.


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.

Compliance with Ethical Standards

Conflict of interest

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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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • William M. Miller
    • 1
  • William C. Miller
    • 1
    • 2
  • Clare Barrington
    • 3
    • 4
  • Sharon S. Weir
    • 1
    • 4
  • Sanny Y. Chen
    • 5
  • Michael E. Emch
    • 1
    • 4
    • 6
  • Audrey E. Pettifor
    • 1
    • 4
  • Gabriela Paz-Bailey
    • 7
  1. 1.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Division of Infectious Diseases, Department of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Department of Health Behavior, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillUSA
  5. 5.Division of Global HIV/AIDSCenters for Disease Control and Prevention – Central America Regional OfficeGuatemala CityGuatemala
  6. 6.Department of GeographyUniversity of North Carolina at Chapel HillChapel HillUSA
  7. 7.Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) Central American OfficeGuatemala CityGuatemala

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