Transgender (TG) women in many settings continue to contend
with barriers to healthcare, including experiences of
stigma and discrimination. Argentina has a universal health care system and
laws designed to promote healthcare access among TG women. However, little is
known about barriers to healthcare access among TG women in this setting. The
aim of this study was to explore individual, social-structural and
environmental factors associated with healthcare avoidance among TG women in
Argentina.
Data were derived from a 2013 nation-wide, cross-sectional
study involving TG women in Argentina. We assessed the prevalence and factors
associated with avoiding healthcare using multivariable logistic regression.
Among 452 TG women included in the study, 184 (40.7%)
reported that they avoided seeking healthcare because of their transgender
identity. In multivariable analysis, factors positively associated with
avoiding seeking healthcare were: having been exposed to police violence, internalized stigma, having experienced discrimination by
healthcare workers or patients, and currently living in the Buenos Aires metropolitan
area. In contrast, TG women with extended
health insurance were less likely to report avoiding healthcare.
A high proportion of TG women in our sample reported
avoiding healthcare. Avoiding healthcare was associated with stigma and
discrimination in healthcare settings, as well as police violence experiences.
Although further research is warranted, these finding suggests that
socio-structural interventions tailored TG women needs are needed to improve
access to healthcare among this population.
Table 1
Baseline characteristics of transgender women included in the study, by whether they reported avoiding healthcare (N = 452)
| Characteristic | Total (%) | Healthcare avoidance | p - value | |
|---|---|---|---|---|
| ( n = 452)* | Yes ( % ) | No (%) | ||
| ( n = 184)* | ( n = 268)* | |||
| Individual level factors | ||||
| Age (median, IQR) | 30 (25 – 37) | 30 (25 – 27) | 31 (24 – 37) | 0.861 |
| Foreign born | 45 (10.0) | 17 (9.2) | 28 (10.5) | 0.673 |
| High school education or greater | 152 (33.8) | 54 (29.5) | 98 (36.7) | 0.113 |
| Extended health insurance | 81 (18.5) | 25 (13.8) | 56 (21.7) | 0.036 |
| Currently employed (other than sex work) | 108 (23.9) | 35 (19.0) | 73 (27.2) | 0.044 |
| History of sex work involvement | 378 (84.6) | 163 (89.1) | 215 (81.4) | 0.028 |
| Self-reported HIV infection | 104 (27.4) | 41 (26.8) | 63 (27.8) | 0.838 |
| Any internalized stigma | 245 (54.2) | 118 (64.1) | 127 (47.4) | <0.001 |
| Social-structural factors | ||||
| Police-related experiences | ||||
| Experienced police violence ever | 243 (53.8) | 128 (69.6) | 115 (42.9) | <0.001 |
| Ever arrested | 354 (79.0) | 157 (85.8) | 197 (74.3) | 0.003 |
| Experiences of perceived discrimination in healthcare settings | ||||
| By healthcare workers ever | 302 (66.8) | 155 (84.2) | 147 (54.9) | <0.001 |
| By other patients ever | 143 (32.1) | 84 (46.4) | 59 (22.4) | <0.001 |
| Environmental factors | ||||
| Current residency in Buenos Aires | 140 (31.0) | 69 (37.5) | 71 (26.5) | 0.013 |
| Stable housing | 355 (78.6) | 143 (77.7) | 212 (79.1) | 0.724 |
*Totals may differ due to non-response on some questions.
IQR: interquartile range.
Full article
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By: 
Brandon DL Marshall, Inés Arístegui, Marcela Romero, Pedro Cahn, Thomas Kerr, and Omar Sued
Brandon DL Marshall, Inés Arístegui, Marcela Romero, Pedro Cahn, Thomas Kerr, and Omar Sued
Fundación
Huésped, Angel Peluffo 3932, Buenos Aires, C1202ABB Argentina
Department of
Epidemiology, Brown University School of Public Health, 121 South Main Street,
Box G-S-121-2, Providence, RI 02912 USA
Center for
Psychology Research, School of Social Sciences, University of Palermo, Mario
Bravo 1259, Buenos Aires, C1175ABW Argentina
Association of
Transvestites, Transsexuals, and Transgenders of Argentina (A.T.T.T.A.), Callao
339 6th floor, Buenos Aires, C1022AAD Argentina
British Columbia
Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard
Street, Vancouver, BC V6Z 1Y6 Canada
Department of
Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard
Street, Vancouver, BC V6Z 1Y6 Canada
María Eugenia Socías, Email: ra.gro.depseuh@saicos.ainegue.
More at: https://twitter.com/hiv_insight
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