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U.S. transgender women’s preferences for microeconomic interventions to address structural determinants of HIV vulnerability: a qualitative assessment

Citation

Poteat T, Mayo-Wilson LJ, Pereira N, et al. U.S. transgender women’s preferences for microeconomic interventions to address structural determinants of HIV vulnerability: a qualitative assessment. BMC Public Health. 2021;21(1):1394. doi:10.1186/s12889-021-11471-8

Implementation stage:

Pre-Implementation

Implementation outcomes reported:

Acceptability

Continuum target addressed:

HIV testing, Linkage to preventative care

Geography:

Missouri

Study Participant Classification:

Recipients of care

Plain Language Objectives

The researchers asked transgender women facing economic hardship what kinds of financial, employment, and support programs they would want and how HIV services could be included without becoming the program’s main focus.

Plain Language Abstract

Economic insecurity can increase HIV vulnerability and make prevention and care harder for transgender women. Researchers interviewed 19 adult transgender women in Richmond, Virginia, and St. Louis, Missouri, who reported sexual risk and recent hardship involving income, employment, housing, or food. Most participants were from racial or ethnic minority groups, their average age was 26.3, 89% were currently economically vulnerable, 23% worked full-time, and 37% lived with HIV. Participants strongly supported flexible, unrestricted vouchers, including funds for gender-affirming needs. They also wanted budgeting and saving support, job preparation, career planning, and access to non-stigmatizing work. Visible transgender leadership, small groups, empowerment, and outreach through existing networks were important. HIV counseling and testing were acceptable, but participants did not want HIV to be the program’s central identity. These qualitative preferences do not show that a financial intervention would reduce HIV risk. The authors concluded that gender-affirming, flexible economic programs should be developed and evaluated.

Key Takeaways

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