ArticleBMC health services research2022
"Lost trust in the system": system barriers to publicly available mental health and substance use services for transgender women in San Francisco.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Smart Contracts and Shared Platforms in Sustainable Health Care: Systematic Review.JMIR medical informatics · 2025Pooled it
- Access to and Experiences with Healthcare Among Transgender Women, San Francisco 2019-2024.AIDS and behavior · 2026Article
- Intersectionality-Informed HIV Cure-Related Research at the End of Life: A Call to Action.International journal of environmental research and public health · 2026Article
- Perceived legal protection and institutional trust predict a lower psychological distress level for transgender people in Aotearoa/New Zealand.International journal of transgender health · 2025Article
- A qualitative study of reasons to use substances and substance use treatment experiences among transgender and gender diverse adults in Rhode Island.SSM. Qualitative research in health · 2024Article
- Clinical and sociodemographic characteristics as predictors for quality of life in transmasculine and transfeminine individuals receiving gender-affirming hormone therapy.Social science & medicine (1982) · 2024Article
- Understanding the delivery of substance use treatment services to transgender and gender-diverse people: Findings from a mixed-methods study of healthcare professionals.Social science & medicine (1982) · 2024Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundLittle is known about the barriers to mental health and substance use services for trans women living with HIV. We conducted a qualitative study with trans women living with HIV and providers to explore barriers to mental health and substance use services in San Francisco.
methodsWe conducted focus group discussions and key informant interviews with a total of 15 medical, mental health, substance use, and social service providers and trans women living with HIV. We identified, analyzed, and reported themes using thematic analysis and derived themes directly from the data.
resultsOur study participants identified two main themes and three subthemes. One main theme is that trans women and providers have lost trust in the system due to (a) lack of a linkage system between referrals and services, (b) structural barriers such as service location, language capacity, clinic hours, and (c) constant changes in services available. Another main theme is anti-trans and mental health stigma.
conclusionsInterventions to coordinate linkage from medical to mental health and substance use (MHSU) services are urgently needed to facilitate the utilization of MHSU services. Other interventions to improve quality monitoring and system improvement, and to address multiple stigmas broadly in society are needed to improve unmet MHSU service needs among trans women living with HIV in San Francisco.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.