Evidence map›Paper›PMID 38245684›Full record

ArticleBMC public health2024

Access to healthcare among transgender women living with and without HIV in the United States: associations with gender minority stress and resilience factors.

Talia A Loeb, Sarah M Murray, Erin E Cooney, Tonia Poteat, Keri N Althoff, Christopher M Cannon, Jason S Schneider, Kenneth H Mayer, J Sonya Haw, Andrew J Wawrzyniak and 7 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
5.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 6 institutions in 1 country.

Talia A LoebDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6014, Baltimore, MD, 21205, USA. tloeb2@jh.edu.
Sarah M MurrayDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Erin E CooneyDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Tonia PoteatDepartment of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Keri N AlthoffDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6014, Baltimore, MD, 21205, USA.
Christopher M CannonWhitman-Walter Institute, Inc., Washington, DC, USA.
Jason S SchneiderDepartment of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Kenneth H MayerThe Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA, 02215, USA.
J Sonya HawDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA, USA.
Andrew J WawrzyniakDepartment of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
Asa E RadixDepartment of Medicine, Callen-Lorde Community Health Center, New York, NY, USA.
Jowanna MaloneWhitman-Walter Institute, Inc., Washington, DC, USA.
Dee AdamsDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6014, Baltimore, MD, 21205, USA.
Megan StevensonDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6014, Baltimore, MD, 21205, USA.
Sari L Reisner *The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA, 02215, USA.
Andrea L Wirtz *Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6014, Baltimore, MD, 21205, USA.
American Cohort to Study HIV Acquisition Among Transgender Women Study Group
Johns Hopkins University · USEmory University · USFenway Health · USCommunity Health Center · USUniversity of Miami · USUniversity of North Carolina at Chapel Hill · US

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI ARTHUR Y KIM · 2004 to 2026
$94.4M
Virology and Molecular Biomarkers CoreP30AI050409 · NIAID · EMORY UNIVERSITY · PI Ann M Chahroudi, Colleen F Kelley · 2002 to 2026
$74.0M
Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Anna Palmer Durbin · 2012 to 2026
$67.0M
University of Miami Developmental Center for AIDS Research (D-CFAR)P30AI073961 · NIAID · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI Savita Pahwa · 2007 to 2026
$33.8M
SWG 2: Cure Research Scientific Working GroupP30AI117970 · NIAID · GEORGE WASHINGTON UNIVERSITY · PI Italo Mocchetti · 2015 to 2026
$29.6M
LITE CONNECT: Addressing testing gaps and epidemiologic disparities of COVID-19 amongtransgender people in the United StatesUH3AI133669 · NIAID · JOHNS HOPKINS UNIVERSITY · PI REISNER, SARI, WIRTZ, ANDREA L · 2019 to 2022
$6.9M
PrEP Engagement Trajectories Among Transgender Women in the United StatesF31MH124582 · NIMH · JOHNS HOPKINS UNIVERSITY · PI COONEY, ERIN EILEEN · 2020 to 2022
$138k
NIAID NIH HHS P30 AI050409NIAID NIH HHS P30 AI060354NIAID NIH HHS P30 AI073961NIAID NIH HHS P30 AI094189NIAID NIH HHS P30 AI117970NIAID NIH HHS UH3 AI133669NIMH NIH HHS F31 MH124582
6 · The paper itself

Abstract

backgroundTransgender women (TW) experience significant inequities in healthcare access and health disparities compared to cisgender populations. Access to non-transition related healthcare is understudied among TW. We aimed to assess the association between access to care and gender minority stress and resilience factors among TW living with and without HIV in eastern and southern United States.

methodsThis study was a cross-sectional analysis of baseline data drawn from a cohort of 1613 adult TW from the LITE Study. The cohort permitted participation through two modes: a site-based, technology-enhanced mode and an exclusively online (remote) mode. Exploratory and confirmatory factor analyses determined measurement models for gender minority stress, resilience, and healthcare access. Structural equation modeling was used to assess the relationships between these constructs. Models were evaluated within the overall sample and separately by mode and HIV status.

resultsHigher levels of gender minority stress, as measured by anticipated discrimination and non-affirmation were associated with decreased access to healthcare. Among TW living with HIV, higher levels of anticipated discrimination, non-affirmation, and social support were associated with decreased healthcare access. Among TW living without HIV in the site-based mode, resilience was positively associated with positive healthcare experiences and inversely associated with barriers to healthcare access. Among TW living without HIV in the online mode, anticipated discrimination was associated with barriers to healthcare access; resilience was positively associated with positive healthcare experiences and inversely associated with barriers to healthcare access.

conclusionsGender minority stress was associated with increased barriers to healthcare access among TW in the US, regardless of HIV status. Resilience factors did not mediate this effect. Interventions aiming to increase healthcare access among TW can be aided by efforts to mitigate drivers of gender minority stress and improve patient experiences in healthcare facilities.

Indexed as

HIV InfectionsResilience, PsychologicalSexual and Gender MinoritiesTransgender PersonsAdultCross-Sectional StudiesFemaleGender IdentityHealth Services AccessibilityHumansMaleUnited StatesGender minority stressHealthcare accessHIVKey populationsResilienceStructural equation modelingTransgender women

Identifiers

PMID38245684
PMCPMC10800069
OpenAlexW4391047585

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.