The Helping Networks of Transgender Women Living with HIV

• Authors: Marinda Hill, University of California San Francisco; Jae Sevelius, University of California San Francisco; Athena Sherman, Emory University; Monique Balthazar, Emory University; Meredith Klepper, Johns Hopkins University; Asa Radix, Callen-Lorde Community Health Center; Greg Rebchook, University of California San Francisco; Nathan Hansen, University of Georgia
• Journal Title: JOURNAL OF COMMUNITY HEALTH
• Volume: Volume 48, Number 3
• Publisher: SPRINGER | 2023-01-20, Pages 480-488
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1007/s10900-022-01179-0
• Subjects: Health Sciences, Nursing; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Health Policy & Services; Public, Environmental & Occupational Health; Health Care Sciences & Services; Community health interventions; Natural helping networks; Transgender women; HIV; AIDS; Social network analysis; HEALTH; CARE

Abstract

Transgender women living with HIV face significant barriers to healthcare that may be best addressed through community-centered interventions holistically focused on their HIV-related, gender-related, and other important needs. Community health ambassador (CHA) interventions (education and training programs designed to engage communities and community leaders in health promotion) may be an effective option, though information about the natural helping networks of this vulnerable population is too limited to inform the implementation of this approach. This study uses social network analysis to describe the natural helping networks of transgender women living with HIV, their help-seeking patterns for HIV-related, gender-related, and ancillary resources, and the characteristics of potential network ambassadors. From February to August 2019, transgender women living with HIV in the US (N = 231) participated a 30-min online survey asking them to describe their natural helping networks (N = 1054). On average, participants were embedded within natural helping networks consisting of 4–5 people. They were more likely to seek help from informal network members vs. formal service providers (p <.01), and from chosen family and partners/spouses (p <.05) above other social connections. Older network members (p <.01), other transgender women (p <.05), and those with whom they regularly engaged face-to-face (p <.01) (vs. social technology) were identified as potential network ambassadors for HIV-, gender-related, and other important issues. These findings suggest an opportunity to develop CHA interventions that leverage existing help networks and potential network ambassadors to promote equitable access to HIV, gender-affirming, and other crucial resources among this medically underserved group.