“We’re Just Targeted as the Flock That Has HIV”: Health Care Experiences of Members of the House/Ball Culture

Rowan, Diana; DeSousa, Maysa; Randall, Ethan Makai; White, Chelsea C.; Holley, Lamont

doi:10.1080/00981389.2014.896847

Cited by 32 publications

(32 citation statements)

References 13 publications

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“…11 Our findings also agree with research suggesting that men can feel stigmatized when providers immediately associate MSM behavior with HIV risk. 42 Our results can contribute to literature on building cultural competence among clinical providers serving MSM and other sexual minority populations. [43][44][45][46][47][48][49][50][51][52][53] We also support recent calls for increased clinical training and cultural competency in MSM healthcare.…”

Section: Discussionmentioning

confidence: 74%

A Qualitative Study of Medical Mistrust, Perceived Discrimination, and Risk Behavior Disclosure to Clinicians by U.S. Male Sex Workers and Other Men Who Have Sex with Men: Implications for Biomedical HIV Prevention

et al. 2015

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Access to biomedical HIV prevention technologies such as pre-exposure prophylaxis (PrEP) requires individuals to disclose risk behavior to clinicians, but experiences of discrimination and medical mistrust may limit disclosure among male sex workers and other MSM. We explored experiences of perceived discrimination, medical mistrust, and behavior disclosure among male sex workers compared to other men who have sex with men (MSM). We conducted 56 interviews with MSM and compared findings about medical mistrust, discrimination, and disclosure for 31 men who engaged in sex work vs. 25 men who did not. MSM who engaged in sex work reported more medical mistrust and healthcare discrimination due to issues beyond MSM behavior/identity (e.g., homelessness, substance use, poverty). MSM who did not report sex work described disclosing sex with men to clinicians more often. Both subgroups reported low PrEP awareness, but willingness to disclose behavior to obtain PrEP. Medical mistrust and perceived discrimination create barriers for sexual behavior disclosure to clinicians, potentially impeding access to PrEP and other forms of biomedical HIV prevention. These barriers may be higher among male sex workers compared to other MSM, given overlapping stigmas including sex work, substance use, homelessness, and poverty. An intersectionality framework for understanding multiple stigmas can help to identify how these dynamics may limit access to biomedical HIV prevention among male sex workers, as well as suggesting strategies for addressing stigmas to improve the delivery of PrEP and other HIV prevention approaches in this population.

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Section: Discussionmentioning

confidence: 74%

A Qualitative Study of Medical Mistrust, Perceived Discrimination, and Risk Behavior Disclosure to Clinicians by U.S. Male Sex Workers and Other Men Who Have Sex with Men: Implications for Biomedical HIV Prevention

et al. 2015

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“…Table 1 summarizes the study design, purpose, data collection method, inclusion and exclusion criteria, sample size, and main findings of the nineteen peer-reviewed studies identified for evaluation regarding health and well-being of HBCs. The table lists the articles in alphabetical order by (Olivas, et al 2019 (Rowan, DeSousa, Randall, White & Holley, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the work completed with the HBC has emphasized the structure of the Houses and their role in HIV prevention (Dickson-Gomez et al, 2014;Kipke, Kubicek, Supan, Weiss, & Schrager, 2013;Murrill, 2008;Phillips, Peterson, Binson, Hidalgo, & Magnus, 2011;Sanchez, Finlayson, Murrill, Guilin, & Dean, 2010;Schrager, Latkin, Weiss, Kubicek, & Kipke, 2014); supportive networks and social structures (Arnold, Sterrett-Hong, (Olivas, et al 2019 (Holloway et al, 2012;Kipke, Kubicek, Supan, Weiss, & Schrager, 2013;; and, partnerships and collaborations (Alio et al, 2014;Castillo, Palmer, Rudy, & Fernandez, 2012). The remaining studies addressed specific health topics related to HIV, such as stigma, (Galindo, 2013), resilience , and access to health care (Rowan, DeSousa, Randall, White, & Holley, 2014). (Olivas, et al 2019) Exploring Health and Wellbeing in the US House Ball Community: A Systematic Review (Olivas, et al 2019) Exploring Health and Wellbeing in the US House Ball Community: A Systematic Review from within the community are most ideal given member experiences with homophobia and stigmatization from outside of the community.…”

Section: Study-specific Findingsmentioning

confidence: 99%

“…HBC members perceived that prevention balls can be effective, however most attendees believe that the message can be lost in ball-related festivities (Rowan et al, 2014). Results suggested that personal, cautionary (Olivas, et al 2019) Exploring Health and Wellbeing in the US House Ball Community: A Systematic Review stories related to HIV were perceived as more effective than slogans and other prevention campaigns, and that HBC participation was need it the disseminating of prevention-related information (Rowan et al, 2014). In addition, health care professional's unfamiliarity with HBCs, financial constraints, and lack of transportation were identified as key barriers to healthcare among this community (Rowan et al, 2014).…”

Section: Study-specific Findingsmentioning

confidence: 99%

“…Results suggested that personal, cautionary (Olivas, et al 2019) Exploring Health and Wellbeing in the US House Ball Community: A Systematic Review stories related to HIV were perceived as more effective than slogans and other prevention campaigns, and that HBC participation was need it the disseminating of prevention-related information (Rowan et al, 2014). In addition, health care professional's unfamiliarity with HBCs, financial constraints, and lack of transportation were identified as key barriers to healthcare among this community (Rowan et al, 2014). Sanchez et al (2010) estimated the prevalence of HIV infection and related risk behaviors among the HBC and found that transgender women were more likely than MSM to report engaging in exchange sex.…”

Section: Study-specific Findingsmentioning

confidence: 99%

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Exploring Health and Wellbeing in the US House Ball Community: A Systematic Review

et al. 2019

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Introduction: The House Ball Community (HBC) has a longstanding, unique history and place among the LGBTQ community. HBCs provide spaces where gender and sexual minorities find support, acceptance, and freedom for self-expression. Although the HBC has been the focus of extensive HIV-related research and intervention, a more holistic view of HBC member health is important. The purpose of this systematic review is to identify health- and wellbeing-related research studies among HBC members to inform future practice. Methods: A systematic review of literature published between 2006 and 2016 was conducted utilizing keywords applied to the CINAHL, PubMed, PsycINFO, and ProQuest databases. Inclusion and exclusion criteria were applied, and articles were scored by multiple reviewers utilizing a developed scoring guide. Results: The review yielded 19 peer-reviewed full-text articles that met search criteria. A majority of studies were qualitative in nature and nearly half of the studies were based in Los Angeles. Studies of house structures and of HIV prevention were most common, followed by supportive social networks and structures, HIV interventions and new prevention approaches, and partnerships and collaborations. Three studies specifically identified stigma, resilience, and access to health care as factors contributing to the health status of HIV-positive individuals. Conclusions: The majority of HBC health research has focused on HIV prevention in urban areas. Future research should examine other health issues (e.g., mental health and substance use) to develop a more robust understanding of HBC health and foster opportunities for developing a variety of health interventions for the HBC. Keywords: house ball community, health, wellbeing

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Experiences and Perspectives of Transgender Youths in Accessing Health Care

et al. 2021

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ransgender and nonbinary people make up around 0.5% of the world's population (25 million people), and most are children, adolescents, and young adults. 1,2 A detailed list of transgender-associated terms and definitions is presented in eTable 1 in the Supplement. Transgender and nonbinary youths face considerable disparities in access to health care and outcomes. 1,[3][4][5][6] They are exposed to stigma and violence, 1 have an increased risk of anxiety and depression, and are more than 20 times more likely to die by suicide than the general population. 1,3 Transgender and nonbinary people have a high prevalence of substance abuse and are more likely to smoke compared with their peers. 1 Transfeminine individuals have a disproportionate burden of HIV infection, with a global prevalence of 20%. 6 In addition to general health care needs, transgender and nonbinary people often require specific medical interventions, namely hormone therapy, gender-affirming surgery, and reproductive care. However, transgender and nonbinary people have reported difficulties in accessing safe treatment and quality care. 5 In many countries, health care for transgender and nonbinary youths are not explicitly addressed in legislation and policy, and patients encounter legal and insurance-associated barriers in accessing care. 3,6 This can lead to disengagement from health services and resorting to nonprescription hormone use or self-performed surgeries, which can lead to life-threatening complications. 7,8 There is very limited understanding of the experiences, challenges, and needs of transgender and nonbinary youths. A systematic review of qualitative studies on the perspectives of transgender and nonbinary youths can generate more comprehensive evidence that spans different populations and health care contexts. We aimed to describe the attitudes and experiences of this population in accessing health care to inform strategies to improve the quality of care and health outcomes. MethodsWe conducted a systematic review and thematic synthesis of primary qualitative studies in which the data were reanalyzed across IMPORTANCE Transgender and nonbinary youths have a higher incidence of a range of health conditions and may paradoxically face limited access to health care. OBJECTIVE To describe the perspectives and needs of transgender youths in accessing health care.EVIDENCE REVIEW MEDLINE, Embase, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature were searched from inception to January 2021. Qualitative studies of transgender youths' perspectives on accessing health care were selected. Results from primary studies were extracted. Data were analyzed using thematic synthesis.FINDINGS Ninety-one studies involving 884 participants aged 9 to 24 years across 17 countries were included. We identified 6 themes: experiencing pervasive stigma and discrimination in health care, feeling vulnerable and uncertain in decision-making, traversing risks to overcome systemic barriers to transitioning, internalizing intense fear of con...

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“We’re Just Targeted as the Flock That Has HIV”: Health Care Experiences of Members of the House/Ball Culture

Cited by 32 publications

References 13 publications

A Qualitative Study of Medical Mistrust, Perceived Discrimination, and Risk Behavior Disclosure to Clinicians by U.S. Male Sex Workers and Other Men Who Have Sex with Men: Implications for Biomedical HIV Prevention

A Qualitative Study of Medical Mistrust, Perceived Discrimination, and Risk Behavior Disclosure to Clinicians by U.S. Male Sex Workers and Other Men Who Have Sex with Men: Implications for Biomedical HIV Prevention

Exploring Health and Wellbeing in the US House Ball Community: A Systematic Review

Experiences and Perspectives of Transgender Youths in Accessing Health Care

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