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Anticipated stigma linked to communication issues between trans women with HIV and providers

Anticipated stigma was associated with communication difficulties between transgender women living with HIV and providers.

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Anticipated stigma has been linked to communication difficulties between transgender women living with HIV and HIV-related service providers.

This is according to a study – “Anticipated Stigma and Social Barriers to Communication Between Transgender Women Newly Diagnosed with HIV and Health Care Providers: A Mediation Analysis” by Isabella Chypriades Junqueira Amarante, Sheri A Lippman, Jae M. Sevelius, et al – that appeared in LGBT Health.

This study particularly wanted to assess whether anticipated stigma (i.e. fear of public mistreatment due to gender identity) impacts communication between transgender women living with HIV who are clients of health care providers. It used baseline data from Trans Amigas, a study conducted in Brazil in 2018, with the study population consisting of 113 transgender women living with HIV, older than 18 years, and residing in the São Paulo metropolitan area. Multivariable logistic regression (α = 0.05), mediation, and bootstrapping were used for the analysis.

The findings included:

  • Fear of public mistreatment had an adjusted odds ratio (aOR) of 7.42 (p = 0.003) for difficulty reporting new symptoms to providers.
  • Concerning fear of public mistreatment, it was found that unemployment had an aOR of 3.62 (p = 0.036); sex work, an aOR of 2.95 (p = 0.041); and issues related to name change in documents, an aOR of 2.71 (p = 0.033).
  • For the indirect effect on difficulty reporting new symptoms, mediated by fear of public mistreatment, unemployment had an aOR of 1.52 (confidence interval [CI] = 0.88–2.24); sex work, an aOR of 1.48 (CI = 0.81–2.52); and name change issues, an aOR of 1.47 (CI = 0.96–2.43).

Indeed, stated the researchers, “anticipated stigma was associated with communication difficulties between transgender women living with HIV and providers.”

On this, they found that “structural factors associated with anticipated stigma could indirectly impact on difficulty reporting new symptoms.”

For the researchers, therefore, it is important to stress the need to consider social contexts that intersect with individual experiences when analyzing communication barriers between providers and patients, and the need to strengthen social policies for transgender women.”


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