{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:38:32Z","timestamp":1792651112305,"version":"4.5.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2021,11,25]],"date-time":"2021-11-25T00:00:00Z","timestamp":1637798400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>\n                    Exposure to stigma, violence, sex work, and substance use are associated with increased HIV risk, but relationships between these factors have not been fully elucidated among transgender women whose data are often aggregated with men who have sex with men and other sexual and gender minorities. Considering this gap, we aimed to identify a serologically confirmed HIV estimate for transgender women and examine the relationships between stigma, sex work, substance use, and HIV among a national sample of transgender women in Dominican Republic. We analyzed biomarkers and self-report data from the third wave of Dominican Republic's Encuesta de Vigilancia y Comportamiento con Vinculaci\u00f3n Serol\u00f3gica, employing logistic and negative binomial regression to estimate models (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009307). HIV rate was 35.8%. Nearly 75% of respondents engaged in sex work. Over 20% reported experiencing violence; 61.6% reported being stigmatized. Participation in sex work was associated with higher levels of stigma [incidence rate ratio (IRR): 1.70,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05]. Respondents who experienced violence had over three times higher odds of living with HIV relative to respondents who had not been victimized [odds ratio (OR): 3.15,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05]. Marijuana users were less likely to experience stigma compared with cocaine users (IRR: 1.72,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05), and a higher risk of alcohol dependency was associated with higher odds of experiencing violence (OR: 1.17,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Findings illustrate the importance of disaggregating data collected from transgender women compared with other sexual and gender minorities to ascertain subpopulation-specific estimates and indicate an urgent need to implement structural interventions and policies to protect transgender women's health and their human rights.\n                  <\/jats:p>","DOI":"10.1089\/apc.2021.0127","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T15:28:55Z","timestamp":1636644535000},"page":"488-494","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":28,"title":["Transgender Women in Dominican Republic: HIV, Stigma, Substances, and Sex Work"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6716-9754","authenticated-orcid":false,"given":"Henna","family":"Budhwani","sequence":"first","affiliation":[{"name":"University of Alabama at Birmingham (UAB), School of Public Health, Department of Health Care Organization and Policy, Birmingham, Alabama, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine R.","family":"Hearld","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham (UAB), School of Public Health, Department of Health Care Organization and Policy, Birmingham, Alabama, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyram A.","family":"Butame","sequence":"additional","affiliation":[{"name":"Florida State University College of Medicine (FSU), Center for Translational Behavioral Science (CTBScience), Tallahassee, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Naar","sequence":"additional","affiliation":[{"name":"Florida State University College of Medicine (FSU), Center for Translational Behavioral Science (CTBScience), Tallahassee, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leandro","family":"Tapia","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical &amp; Salud Global, Universidad Iberoamericana (UNIBE), Santo Domingo, Dominican Republic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Paulino-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical &amp; Salud Global, Universidad Iberoamericana (UNIBE), Santo Domingo, Dominican Republic."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,11,25]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12400"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000031"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181a267e4"},{"key":"e_1_3_5_5_2","unstructured":"AVERT. HIV and AI DS in Latin America: The Caribbean Regional Overview. 2018. Available at: https:\/\/www.avert.org\/professionals\/hiv-around-world\/latin-america\/overview (Last accessed November9 2020)."},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0186457"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2019.1608253"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000906"},{"key":"e_1_3_5_9_2","unstructured":"ONUSIDA. El Estado epid\u00e9mico del VIH en la Republica Dominicana Direcci\u00f3n General de Control de Infecciones de Transmisi\u00f3n sexual y SIDA. Santo Domingo Dominican Republic 2014."},{"key":"e_1_3_5_10_2","unstructured":"UNAIDS. HIV modes of transmission model: Analysis of the distribution of new HIV infections in the Dominican Republic and recommendations for prevention. 2010. Available at: https:\/\/www.unaids.org\/sites\/default\/files\/en\/media\/unaids\/contentassets\/documents\/countryreport\/2010\/201011_MOT_DominicanRepublic_en.pdf (Last accessed October23 2021)."},{"key":"e_1_3_5_11_2","unstructured":"CONAVIHSIDA. Second Behavioral Surveillance Survey with Serological Linkage in Key Populations: UNFPA. 2012. Available at: http:\/\/www.conavihsida.gob.do\/ (Last accessed October23 2021)."},{"key":"e_1_3_5_12_2","unstructured":"CONAVIHSIDA. Segunda Encuesta de Vigilancia de Comportamiento con Vinculaci\u00f3n Serol\u00f3gica en Poblaciones Claves: Gais Trans y Hombres que tienen sexo con hombres (GTH) Trabajadoras sexuales (TRSX) Usuarios de Drogas (UD). Santo Domingo Dominican Republic 2014. Available at: https:\/\/mcr-comisca.org\/actividades-regionales\/febrero-2014-curso-de-malaria\/encuestas-de-vigilancia-de-comportamiento-evc\/87-encuesta-de-vigilancia-de-comportamiento-en-vinculacion-serologica-en-poblaciones-claves-de-republica-dominicana-2012\/file (Last accessed October23 2021)."},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1451-5"},{"key":"e_1_3_5_14_2","unstructured":"Goffman E. Stigma: Notes on the Management of Spoiled Identity. Upper Saddle River NJ: Prentice Hall 1963."},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-009-9593-3"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0437-9"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-03071-1"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/trgh.2017.0032"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053932"},{"key":"e_1_3_5_20_2","unstructured":"PAHO. Blueprint for the Provision of Comprehensive Care for Trans Persons and Their Communities in the Caribbean and Other Anglophone Countries. Arlington VA: John Snow Inc. 2014."},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.2889"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2013.25.1.62"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.04.008"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0657-z"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/15532739.2019.1596862"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18105213"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.20882\/adicciones.775"},{"key":"e_1_3_5_28_2","first-page":"499","article-title":"Validation of the AUDIT test for identifying risk consumption and alcohol use disorders in women","volume":"36","author":"P\u00e9rula de Torres LA","year":"2005","unstructured":"P\u00e9rula de Torres LA, , Fern\u00e1ndez-Garc\u00eda JA, , Arias-Vega R, et al. Validation of the AUDIT test for identifying risk consumption and alcohol use disorders in women. Aten Primaria, 2005; 36:499\u2013506.","journal-title":"Aten Primaria"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1995.tb03552.x"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2020.0056"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2019.0067"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.20.01\/21422"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2020.0148"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.3.20799"}],"container-title":["AIDS Patient Care and STDs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/apc.2021.0127","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/apc.2021.0127","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/apc.2021.0127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:04:08Z","timestamp":1777399448000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/apc.2021.0127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,25]]},"references-count":33,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1089\/apc.2021.0127"],"URL":"https:\/\/doi.org\/10.1089\/apc.2021.0127","relation":{},"ISSN":["1087-2914","1557-7449"],"issn-type":[{"value":"1087-2914","type":"print"},{"value":"1557-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,25]]}}}