Three Site Exploration Into The Cyclical Nature of HIV Vulnerability Experienced by Transgender Women: The Journey from Survival to Survivor Restricted; Files Only
Chumlongluk, Elle (Spring 2024)
Abstract
Background: Transgender women experience a significant burden of HIV infection. Globally, transgender women are 49 times more likely to experience HIV infection. In the United States, 4 in 10 transgender women identify as HIV positive. Due to the lack of acceptance of their gender identity in society, transgender women experience discrimination in healthcare, employment, and housing which can impact HIV vulnerability. More research is needed to understand the interconnectedness of these areas of discrimination and how that impacts HIV prevention, care, and treatment. Additionally, community connectedness, social support, and familial support have all been shown to help increase resilience; however, few studies have examined the role of social support, sources of empowerment, and the impact it has on HIV prevention, care, and treatment for transgender women.
Objective: This study aimed to assess how transgender women describe their lived experiences related to HIV prevention, care, and treatment through a qualitative secondary data analysis.
Methods: 40 semi-structured in-depth interviews with 20 participants living with HIV and 20 participants living without HIV were utilized for this study. Thematic analysis was applied to evaluate deductive and inductive codes.
Results: There were multiple themes that emerged as barriers to HIV prevention, care, and treatment including the cyclical nature of discrimination and various types of identified survival needs. However, there were many sources of empowerment that participants commonly referred to that allowed them access to the HIV care that they needed. Additionally, there were some individuals that achieved a true sense of survivorship within themselves and their experiences.
Discussion: From these emerging themes, a heuristic cycle was formed linking each of the themes together. Further research is needed to understand if these interconnected patterns exist with other demographic populations. The research presented can potentially guide future comprehensive interventions and policy and program development.
Table of Contents
TABLE OF CONTENTS
CHAPTER ONE: Introduction, 1
CHAPTER TWO: Comprehensive Literature Review, 3
CHAPTER THREE: Methodology, 8
A. Sample and Recruitment Methods, 8
B. Data Collection Methods, 9
C. Data Analysis, 9
D. Ethical Considerations, 10
E. Positionality and Reflection, 10
CHAPTER FOUR: Results, 12
A. Participant Characteristics, 12
B. Main Themes, 14
C. The Cyclical Nature of Discrimination, 14
D. Survival as a Transgender Woman, 18
I. Survival: Feeling Comfortable in One’s Own Skin and Sense of Identity, 18
II. Survival: Basic Human Needs, 20
III. Survival: HIV Diagnosis, 23
E. Sources of Empowerment, 24
I. Trust in Providers and Gender Affirming Care, 25
II. Support from Social Networks and Support Groups, 27
III. Perseverance Through Adversity and Discrimination, 28
F. A True Sense of Survivorship, 30
I. The Sense of Feel Comfortable in One’s Own Skin Brings Strength and Confidence, 30
II. Mentorship, Activism, and Representation for Transgender Women, 32
CHAPTER FIVE: Discussion, Public Health Implications, and Conclusions, 36
A. Discussion, 36
B. Strengths and Limitations, 41
C. Future Directions and Public Health Implications, 42
D. Conclusion, 44
References, 45
Appendices, 48
A. Appendix A: Demographic Questionnaire, 48
B. Appendix B: Interview Guide for HIV Negative Transgender Women, 50
C. Appendix C: Interview Guide for HIV Positive Transgender Women, 61
D. Appendix D: Codebook, 75
About this Master's Thesis
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File download under embargo until 20 May 2026 | 2024-04-25 11:15:49 -0400 | File download under embargo until 20 May 2026 |
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