ABSTRACT
BACKGROUND: Transgender women (TW) in Puerto Rico (PR) face social stigmatization. Physicians' transgender stigma can have detrimental consequences for TW's health. PURPOSE: The objective of this study was to document physicians' knowledge, competencies, and attitudes towards TW in PR and study their associations with stigma towards TW. METHODS: We implemented an exploratory sequential mixed-methods study. We used in-depth interviews (n=30) and self-administered questionnaire (n=255). RESULTS: Qualitative results illustrated lack of recognition of the needs of TW; they also evidenced the impact of stigmatizing attitudes on clinical decisions. Quantitative results showed that more willingness and knowledge to provide health services to TW were negatively associated with stigma. Participants who reported history of training in working with TW presented significantly less stigma than participants who had not received such training. CONCLUSION: In order to provide stigma-free services for TW in PR, specialized training regarding the particular needs of this population is needed.
Subject(s)
Attitude of Health Personnel , Physicians/psychology , Stereotyping , Transgender Persons/psychology , Adult , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Puerto RicoABSTRACT
The assessment of biomarkers related to HIV and chronic stress increases opportunities for the design of more comprehensive research and intervention efforts on the health of transwomen within the context of Health Psychology. In this paper, we present data from a study implemented in Puerto Rico that aimed to: document the feasibility/acceptability of collecting biomarkers for chronic stress and HIV among transwomen; qualitatively document the factors related to the collection of biomarkers in this population; and explore the feasibility of collecting other types of biological specimens from transwomen in future studies. We implemented an exploratory mixed-method study with a sample of 10 transwomen. Quantitative information was gathered via saliva and hair biomarkers for chronic stress and HIV, while qualitative data was obtained via in-depth interviews. Twenty percent had positive results for HIV antibodies and 30% had hair cortisol levels that exceeded the normal range. The main motivations behind the provision of biomarkers were the desire to know about their health; contributing to a better understanding of health in the transgender community; and having previous positive experiences with our research team. We discuss the incorporation of biomarkers as powerful tools to better describe and understand the health of transwomen.
ABSTRACT
Project Cuídalos aimed to test the efficacy of a web-based intervention aiming to increase communication on sexual health topics between parents and adolescents in the Puerto Rican population. To achieve this goal, we implemented a longitudinal experimental design which examined whether the intervention would impact communication about sexuality between the participants (N=1,320). Parents completed a web-based interactive module in recruitment centers throughout Puerto Rico. Afterwards, parents could revisit the web-based workshop on their own. The process of accessing the workshop proved to be challenging. To explore why, we expanded our design and incorporated a qualitative component that included semi-structured telephone interviews to 23 randomly selected participants. After transcribing the interviews, we conducted a content analysis from which six thematic categories emerged: 1) perceived impact of the module in the parent-adolescent relationship, 2) communication between research team and parents, 3) platform to access the module, 4) assistance to complete the module, 5) remote access to the module, and 6) changes to the module for future implementations. Our findings will allow us to refine our intervention and offer recommendations to similar efforts using the Internet to increase their impact.
ABSTRACT
Men who have sex with men (MSM) are one of the most affected populations by HIV/AIDS. Over the last years an increase of cases has been reported in younger groups. The Center for Disease Control and Prevention has stated that stigma and homophobia may have a profound impact on the lives of MSM, and could influence them to engage in HIV risky behaviors. In the U.S and Puerto Rico, an increase in HIV cases among young MSM has been reported. For the period of 2005-2009 an increase of HIV cases was reported with 4.3% in the age group of 13-24 and 55.6% in the age group of 25-34. Understanding the dynamics related HIV risk behaviors among young MSM requires transcending traditional individual behavior oriented perspectives in order to adopt a more comprehensive socio-structural approach. In this manuscript we present a critical analysis of HIV prevention issues among young MSM in Puerto Rico.
ABSTRACT
The HIV/AIDS epidemic continues to impact Puerto Rico and the Caribbean region with growing numbers of cases each year. The stigma that surrounds the epidemic has harmful implications on the health of people living with the disease and public health in general, fostering health deterioration and new infections. When this stigma emanates from health professionals it can severely hinder access to health services, which are crucial for those living with the virus. Still, AIDS stigma has been previously explored among this population as a separate phenomenon from other pre-existing stigmas. This has yielded a limited perspective on the complexity of how AIDS stigma is manifested. In light of this limitation, the main objectives of this study were: 1) to document AIDS stigma among a sample of Puerto Rican health professionals and health professionals in training and 2) to explore the combination of other stigmas (sexism, homophobia, and negative attitudes towards drug users) with that associated to HIV/AIDS. Through an exploratory design, using a mixed method approach (qualitative in-depth interviews and quantitative questionnaires), we explored the objectives in a sample of 501 health professionals and health professionals in training. The results evidenced the combinations of other stigmas with that of HIV/AIDS. Homophobia yielded the strongest correlation and was the best predictor of AIDS stigma. These results evidence the need to develop interventions to reduce AIDS stigma and its combinations among this population.
Subject(s)
Acquired Immunodeficiency Syndrome , Attitude of Health Personnel , Stereotyping , Adult , Female , Humans , Interviews as Topic/methods , Male , Puerto Rico , Surveys and QuestionnairesABSTRACT
El proceso de estigmatización asume una devaluación de la persona debido a una característica o marca que haya sido identificada socialmente y que permita que se le describa como diferente. Desde que se desató la epidemia del VIH/SIDA, vivir con la enfermedad ha sido señalado de manera social como una marca estigmatizante. Las manifestaciones de dicha estigmatización se han documentado entre profesionales de la salud. Este estigma puede afectar los servicios de salud que las personas que viven con VIH/SIDA reciben de estos profesionales. Los objetivos de esta investigación fueron explorar: 1) la percepción que tienen estudiantes y profesionales de la salud sobre su nivel de competencia para ofrecer servicios a personas que viven con VIH/SIDA, 2) las opiniones de éstos sobre el tipo de adiestramiento profesional recibido y la necesidad del mismo, y 3) la manifestación de actitudes estigmatizantes como indicadores de necesidad de adiestramiento profesional. La muestra total del estudio estuvo compuesta por 80 de diversas profesiones de la salud. Los resultados reflejan que algunos/as de los/as participantes han recibido formación en VIH pero ésta no ha sido suficiente para contrarrestar las nociones estigmatizantes. Discutimos las implicaciones de los resultados para investigaciones futuras y el desarrollo de intervenciones con vías de minimizar las nociones estigmatizantes en los escenarios de salud.
ABSTRACT
Las profesiones de la salud tienen un papel social dual. Por un lado, velan por el mantenimiento de la salud de la población protegiendo el bien común. Por el otro, dictaminan las formas saludables, y por lo tanto socialmente apropiadas, de ser, actuar y pensar. Este último papel, está más ligado al control social de la población que a una preocupación altruista hacia la misma. A través de esta supervisión y control, se construyen los sujetos a los cuales todos/as debemos aspirar a ser para gozar de aceptación social. Los/as profesionales de la salud han jugado un rol protagónico en dicho proceso, siendo los agentes que delimitan y definen lo que es enfermo vs. saludable, útil vs. inútil, apropiado vs. inapropiado. En el caso de la epidemia del VIH, este esfuerzo se ha hecho cada vez más vigente ya que estos/as profesionales juegan un papel importante en el tratamiento de las personas que viven con VIH/SIDA (PVVS). Sin embargo, su función está plasmada de definiciones que sirven para criminalizar a las PVVS. El objetivo de este estudio fue explorar la manera en que una muestra de profesionales de la salud en Puerto Rico construyen a las PVVS. Con este propósito, entrevistamos 80 profesionales de la salud y estudiantes de estas profesiones. Estas entrevistas fueron grabadas, transcritas y sometidas a un análisis de discurso. Los resultados reflejaron que según las personas participantes: 1) la PVVS no es una persona "normal" o funcional bajo los estándares sociales debido a que su salud no se los permite, 2) representa una carga para la sociedad incluyendo familiares, amigos/as, el mundo del trabajo, e incluso para el gobierno, 3) debe ser vigilada porque representa un riesgo para la persona seronegativa que es descrita como saludable y productiva, y 4) necesita que su salud y conducta sexual sean controladas por vía legal y/o por las personas que representan las instituciones sociales, como lo son los/as profesionales de la salud. En este artículo abordamos el potencial rol de la psicología para servir como vehículo de reconstrucción de dichas nociones, tomando en consideración su propio rol en la formación y mantenimiento de dicho sujeto socialmente deseable.
