Understanding HIV Disparities among Transgender Women in Guatemala: Linking Social and Structural Factors to HIV Vulnerability

Barrington, Clare; Galindo Arandi, César; Aguilar-Martínez, José Manuel; & Miller, William M. (2018). Understanding HIV Disparities among Transgender Women in Guatemala: Linking Social and Structural Factors to HIV Vulnerability. In Kerrigan, Deanna L., Barrington, Clare, Kalichman, Seth C., Kippax, Susan, Parker, Richard G. & de Wit, John (Eds.), Structural Dynamics of HIV: Risk, Resilience and Response (pp. 3-17). New York: Springer International Publishing.

Barrington, Clare; Galindo Arandi, César; Aguilar-Martínez, José Manuel; & Miller, William M. (2018). Understanding HIV Disparities among Transgender Women in Guatemala: Linking Social and Structural Factors to HIV Vulnerability. In Kerrigan, Deanna L., Barrington, Clare, Kalichman, Seth C., Kippax, Susan, Parker, Richard G. & de Wit, John (Eds.), Structural Dynamics of HIV: Risk, Resilience and Response (pp. 3-17). New York: Springer International Publishing.

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Transgender women experience dramatic HIV disparities across the globe. In Guatemala, HIV prevalence among transgender women is over 23.0% compared to 0.8% nationally. Understanding and addressing this disparity requires a holistic perspective that recognizes the synergistic role of social and structural factors throughout the life course. In this chapter we analyze qualitative in-depth interviews with eight transgender women in Guatemala City to explore how social and structural factors contribute to heightened HIV vulnerability. Specifically, we aim to identify mechanisms of influence between the syndemics of social exclusion, stigma, discrimination, and violence and HIV vulnerability. Participants described a context in which transgender stigma is a ubiquitous part of their daily lives. One of the most destructive manifestations of this stigma was family exclusion, which led to participants living in extreme poverty, having limited economic opportunities, and relying on sex work. Violence throughout the life course was another critical mechanism through which stigma impacted HIV vulnerability. Violence also enhanced opportunities for HIV risk, in particular unprotected sex with clients and other partners. Responding to the cumulative effect of these synergistic factors will require innovative, multi-level strategies that engage individuals, families and communities at multiple levels.




CHAP

Structural Dynamics of HIV: Risk, Resilience and Response

Social Aspects of HIV

Barrington, Clare
Galindo Arandi, César
Aguilar-Martínez, José Manuel
Miller, William M.

Kerrigan, Deanna L.
Barrington, Clare
Kalichman, Seth C.
Kippax, Susan
Parker, Richard G.
de Wit, John

Aggleton, Peter

2018



4


3-17




Springer International Publishing

New York





10811

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