Transgender and Other Gender-Diverse Youth's Progression Through the HIV Continuum of Care: Socioecological System Barriers

TitleTransgender and Other Gender-Diverse Youth's Progression Through the HIV Continuum of Care: Socioecological System Barriers
Publication TypePublication
Year of Publication2019
AuthorsHarper GW, Jadwin-Cakmak LA, Popoff E, Campbell BAnne, Granderson R, Wesp LM
Corporate AuthorsAdolescent Medicine Trials Network for HIV/AIDS Interventions
JournalAIDS Patient Care STDS
Volume33
Issue1
Pagination32-43
Date Published2019 Jan
ISSN1557-7449
Abstract

Transgender and other gender-diverse youth (TGDY) are disproportionately affected by HIV and in need of developmentally and culturally appropriate services as they progress along the HIV continuum of care (CoC). We conducted a phenomenological analysis of 66 in-depth interviews with TGDY living with HIV (ages 16-24) from 14 cities across the United States about their experiences within the different stages of the HIV CoC. TGDY described experiencing a wide variety of barriers across each examined stage of the HIV CoC, including HIV testing, linkage to care, retention in care, initiation of antiretroviral therapy, and adherence to antiretroviral therapy. Within these CoC stages, TGDY experienced barriers to care across all socioecological systems, including the sociocultural systems, clinic/organizational systems, and interpersonal systems. Barrier themes remained relatively constant for all stages of the CoC, although the way each thematic category of barrier (e.g., the theme of societal oppression and discrimination within the sociocultural level) was experienced varied by stage. Although overall thematic categories were typically not focused solely on threats to participants' gender identity and expression, specific descriptions of the nature of the thematic barriers were related to gender identity and gender expression. Implications of the findings for future research and practice are discussed.

DOI10.1089/apc.2018.0078
Alternate JournalAIDS Patient Care STDS
PubMed ID30601061
PubMed Central IDPMC6338455
Grant ListU01 HD040474 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States