{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:11:40Z","timestamp":1777921900684,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"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":["LGBT Health"],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Globally, transgender women (TGW) experience wide-ranging barriers to health and care, with disproportionately high risks of infectious and chronic diseases. Yet, research on transgender populations' access to care in low- and middle-income countries remains limited, focused on human immunodeficiency virus (HIV) infection, and assesses TGW as a homogenous group. We analyzed morbidity and health service uptake patterns among TGW in Lima, Per\u00fa, to understand health outreach and service needs to inform targeting and design of community-level interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study surveyed a convenience sample of 301 TGW in metropolitan Lima during September\u2013October 2020. We report descriptive statistics and bivariable and multivariable regression model results as adjusted prevalence ratios (aPRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Health coverage and access to care were suboptimal. Less education and older age were positively associated with illness and negatively associated with HIV and tuberculosis (TB) testing. In the first study to quantitatively examine health utilization by gender identity subgroup (i.e., woman, trans or transgender, transsexual, \u201ctransformista,\u201d \u201ctravesti,\u201d and other) in Per\u00fa, TGW who identified as women were more likely to ever test for HIV (aPR\u2009=\u20091.49, 95% confidence interval [CI]: 1.16\u20131.91) and use pre-exposure prophylaxis (PrEP) (aPR\u2009=\u20092.36, 95% CI: 1.15\u20134.80). Both awareness and interest regarding PrEP were low, as was usage among those who were interested in taking PrEP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Public health efforts should be tailored to meet TGW's diverse needs, expand TB testing, bridge the gap between PrEP interest and use, and increase insurance coverage and access to trans-friendly services for improved health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lgbt.2022.0054","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T09:52:37Z","timestamp":1682329957000},"page":"535-543","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Cross-Sectional Analysis of Self-Reported Needs and Health Service Utilization Among Transgender Women in Lima, Per\u00fa"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6166-9734","authenticated-orcid":false,"given":"Elizabeth A.","family":"Carosella","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA."},{"name":"Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leyla","family":"Huerta","sequence":"additional","affiliation":[{"name":"F\u00e9minas de Lima, Lima, Per\u00fa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8732-6959","authenticated-orcid":false,"given":"Jerome T.","family":"Galea","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA."},{"name":"School of Social Work, University of South Florida, Tampa, Florida, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonid","family":"Lecca","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Partners In Health\/Socios En Salud Sucursal Per\u00fa, Lima, Per\u00fa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Ramos","sequence":"additional","affiliation":[{"name":"Partners In Health\/Socios En Salud Sucursal Per\u00fa, Lima, Per\u00fa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noris G.","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Partners In Health\/Socios En Salud Sucursal Per\u00fa, Lima, Per\u00fa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly F.","family":"Franke","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"Peinado","sequence":"additional","affiliation":[{"name":"Partners In Health\/Socios En Salud Sucursal Per\u00fa, Lima, Per\u00fa."},{"name":"Faculty of Health Sciences, School of Medicine, Peruvian University of Applied Sciences, Lima, Per\u00fa."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,10,4]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.11.010"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/AITC201907020"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-13-0493"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00684-X"},{"key":"e_1_3_5_6_2","unstructured":"TvT Project. Trans Day of Remembrance (TDoR) 2018 Press Release. TvT Project: Berlin Germany; 2018. Available from: https:\/\/transrespect.org\/en\/tmm-update-tdor-2018\/ [Last accessed: September27 2021]."},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-02889-z"},{"key":"e_1_3_5_8_2","unstructured":"UNAIDS. The Injustices Faced by Transgender Women in Per\u00fa. UNAIDS: Geneva Switzerland; 2018. 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UCSF Prevention Science Department of Medicine: San Francisco CA USA; 2022. Available from: https:\/\/prevention.ucsf.edu\/transhealth\/education\/data-recs-summary [Last accessed: October27 2021]."},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25974"},{"key":"e_1_3_5_21_2","unstructured":"World Health Organization. Global tuberculosis report 2020. World Health Organization: Geneva Switzerland; 2020. Available from: https:\/\/www.who.int\/publications-detail-redirect\/9789240013131 [Last accessed: October27 2021]."},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41182-020-00293-w"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2016.1167932"},{"key":"e_1_3_5_24_2","unstructured":"Lee Badgett MV Baker KE Conron KJ et al. The GenIUSS Group. Best practices for asking questions to identify transgender and other gender minority respondents on population-based surveys. The Williams Institute: Los Angeles CA USA; 2014. Available from: https:\/\/williamsinstitute.law.ucla.edu\/publications\/geniuss-trans-pop-based-survey\/[Last accessed: October27 2021]."},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303578"},{"key":"e_1_3_5_26_2","unstructured":"M Pun. Situaci\u00f3n de la epidemia de VIH en Per\u00fa. [Situation of the HIV epidemic in Peru]. Red Nacional de Epidemiologia [National Network of Epidemiology]: Lima Peru; 2015. Available from: https:\/\/web.kamihq.com\/web\/viewer.html?source=extension_pdfhandler&file=https%3A%2F%2Fwww.minsa.gob.pe%2Fportada%2FEspeciales%2F2015%2Fvih%2Fmatcom%2FSituacion-Epidemiologica-VIH-2015.pdf [Last accessed: October27 2021]."},{"key":"e_1_3_5_27_2","unstructured":"\u00bfQu\u00e9 es el VIH y SIDA? Plataforma digital \u00fanica del Estado Peruano [What is HIV and AIDS? Single digital platform of the Peruvian State]. 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