Reduction of Gender Identity Stigma and Improvements in Mental Health Among Transgender Women Initiating HIV Treatment in a Trans-Sensitive Clinic in Argentina

Pablo D Radusky; Virginia Zalazar; Nadir Cardozo; Solange Fabian; Mariana Duarte; Claudia Frola; Pedro Cahn; Omar Sued; Inés Aristegui

doi:10.1089/trgh.2020.0005

Reduction of Gender Identity Stigma and Improvements in Mental Health Among Transgender Women Initiating HIV Treatment in a Trans-Sensitive Clinic in Argentina

Transgend Health. 2020 Dec 11;5(4):216-224. doi: 10.1089/trgh.2020.0005. eCollection 2020 Dec.

Authors

Pablo D Radusky^{1

2}, Virginia Zalazar¹, Nadir Cardozo^{1

3}, Solange Fabian^{1

4}, Mariana Duarte^{1

3}, Claudia Frola^{1

5}, Pedro Cahn¹, Omar Sued¹, Inés Aristegui^{1

6}

Affiliations

¹ Research Department, Fundación Huésped, Buenos Aires, Argentina.
² Faculty of Psychology, Universidad de Buenos Aires, Buenos Aires, Argentina.
³ Association of Transvestites, Transsexuals, and Transgenders of Argentina (A.T.T.T.A.), Buenos Aires, Argentina.
⁴ Asociación Civil Hotel Gondolin, Buenos Aires, Argentina.
⁵ Infectious Diseases Unit, Juan A. Fernández Hospital, Buenos Aires, Argentina.
⁶ Infectious Diseases Unit, Universidad de Palermo, Buenos Aires, Argentina.

Abstract

Purpose: Stigma toward transgender women (TGW) increases psychosocial vulnerability, leading to poor mental health and affecting access and retention in HIV care. Trans-sensitive health care (TSHC) has the potential to mitigate this adverse impact. This study aimed to describe baseline characteristics in gender identity stigma (GIS), mental health, and substance use among TGW living with HIV initiating antiretroviral treatment and to analyze changes after 6 months in HIV care in a TSHC clinic in Argentina. Methods: Sixty-one TGW living with HIV responded to the following questionnaires at baseline and after 6 months in TSHC: sociodemographic, experiences of GIS (in health care, police, etc.), Center for Epidemiologic Studies Depression Scale (CES-D) (depression), State Trait Anxiety Inventory (STAI) (anxiety), Drug Abuse Screening Test (DAST-10) (drug use), Alcohol Use Disorders Identification Test (AUDIT) (alcohol use), 8-item Personal Wellbeing Index-Adults (PWI-A) (quality of life [QOL]), Personality Inventory for DSM-5-Brief Form (PID-5-BF) (maladaptive personality traits), and Duke Index (social support). Analyses included Pearson correlations to analyze associations between variables; and paired sample t-tests, to explore changes between baseline and 6 months. Results: A significant proportion experienced episodes of GIS the last year in any context. At baseline, 50.8% showed significant depressive symptoms and 65.6% reported any drug use in the last year. At 6 months, participants experienced a significant reduction of GIS, both enacted and internalized, anxiety, drug, and alcohol use, and improvement in QOL. The remaining mental health indicators were not significantly modified. Conclusion: A TSHC service may have a gender-affirmative impact on TGW initiating HIV care that contributes to reduce GIS and substance use and improve mental health. This highlights the importance that HIV care programs for TGW comply with trans-sensitive essential components to enhance retention.

Keywords: HIV; gender identity stigma; mental health; trans-sensitive health care; transgender women.