HIV, HCV, HBV, and syphilis among transgender women from Brazil

Abstract

Different sampling strategies, analytic alternatives, and estimators have been proposed to better assess the characteristics of different hard-to-reach populations and their respective infection rates (as well as their sociodemographic characteristics, associated harms, and needs) in the context of studies based on respondent-driven sampling (RDS). Despite several methodological advances and hundreds of empirical studies implemented worldwide, some inchoate findings and methodological challenges remain. The in-depth assessment of the local structure of networks and the performance of the available estimators are particularly relevant when the target populations are sparse and highly stigmatized. In such populations, bottlenecks as well as other sources of biases (for instance, due to homophily and/or too sparse or fragmented groups of individuals) may be frequent, affecting the estimates.In the present study, data were derived from a cross-sectional, multicity RDS study, carried out in 12 Brazilian cities with transgender women (TGW). Overall, infection rates for HIV and syphilis were very high, with some variation between different cities. Notwithstanding, findings are of great concern, considering the fact that female TGW are not only very hard-to-reach but also face deeply-entrenched prejudice and have been out of the reach of most therapeutic and preventive programs and projects.We cross-compared findings adjusted using 2 estimators (the classic estimator usually known as estimator II, originally proposed by Volz and Heckathorn) and a brand new strategy to adjust data generated by RDS, partially based on Bayesian statistics, called for the sake of this paper, the RDS-B estimator. Adjusted prevalence was cross-compared with estimates generated by non-weighted analyses, using what has been called by us a naïve estimator or rough estimates.

Characteristics of hormone use by travestis and transgender women of the Brazilian Federal District

“…This effect is known as homophilia 17 . For this reason, Bastos et al 16 point out that the findings of the study cannot be extrapolated either to the country, or even to the city/ study site, thus only being representative of the researched network itself.…”

“…For travestis and transgender women, homornalization consists in the administration of estrogen by oral or injectable route and antiandrogens that block the excessive action of testosterone 14,15 . This process should be individualized, based on personal goals, risk/benefit ratio of medications and health conditions, and take into account socioeconomic issues 16 .…”

Factors associated with clearance of hepatitis B virus surface antigen in patients infected with human immunodeficiency virus

“…Since the hepatitis B virus (HBV) and human immunodeficiency virus (HIV) are transmitted from human to human by similar pathways, patients with HIV infection are at a high risk of HBV coinfection [ 1 , 2 ] as well as other sexually transmitted infections. [ 3 ] According to the data from Western countries, the rate of coinfection varies among risk categories. The rate is highest among men who have sex with men (MSM), slightly lower among intravenous drug users, and much lower in individuals infected through heterosexual contacts.…”

Factors associated with attitudes towards HIV cure research among transgender women and travestis: a cross-sectional survey in São Paulo, Brazil

“…16 At the structural level, the transgender community continues to face enormous barriers to obtaining higher education, entering the formal labour market, and securing employment. 17 Previous studies report that only 16.7% of transgender individuals in São Paulo, Brazil, worked within the formal labour market, with almost 40% involved in sex work. 18 This can be attributed to the country's lack of equal opportunities, discriminatory public policies, limited protections for transgender individuals and the use of sex work as a means of economic survival.…”

“…18 This can be attributed to the country's lack of equal opportunities, discriminatory public policies, limited protections for transgender individuals and the use of sex work as a means of economic survival. 17 From a social and interpersonal perspective, the transgender population is also disproportionately at risk for experiencing physical and systemic violence due to deep-rooted stigma and transphobia, often in connection to their HIV status. 19 This is further complicated by other intersecting factors, including race and gender identity, with Black and travesti-identifying individuals at a greater risk for both physical violence and HIV infection in comparison to their non-Black and transgenderidentifying counterparts.…”