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Syndemic violence victimization, alcohol and drug use, and HIV transmission risk behavior among HIV-negative transgender women in India: A cross-sectional, population-based study

Transgender women globally are disproportionately burdened by HIV. Co-occurring epidemics of adverse psychosocial exposures accelerate HIV sexual risk, including among transgender women; however, studies using additive models fail to examine synergies among psychosocial conditions that define a synd...

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Autores principales: Chakrapani, Venkatesan, Lakshmi, P. V. M., Newman, Peter A., Kaur, Jasvir, Tsai, Alexander C., Vijin, P. P., Singh, Bhawani, Kumar, Pradeep, Rajan, Shobini, Kumar, Rajesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021466/
https://www.ncbi.nlm.nih.gov/pubmed/36962491
http://dx.doi.org/10.1371/journal.pgph.0000437
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author Chakrapani, Venkatesan
Lakshmi, P. V. M.
Newman, Peter A.
Kaur, Jasvir
Tsai, Alexander C.
Vijin, P. P.
Singh, Bhawani
Kumar, Pradeep
Rajan, Shobini
Kumar, Rajesh
author_facet Chakrapani, Venkatesan
Lakshmi, P. V. M.
Newman, Peter A.
Kaur, Jasvir
Tsai, Alexander C.
Vijin, P. P.
Singh, Bhawani
Kumar, Pradeep
Rajan, Shobini
Kumar, Rajesh
author_sort Chakrapani, Venkatesan
collection PubMed
description Transgender women globally are disproportionately burdened by HIV. Co-occurring epidemics of adverse psychosocial exposures accelerate HIV sexual risk, including among transgender women; however, studies using additive models fail to examine synergies among psychosocial conditions that define a syndemic. We examined the impact of synergistic interactions among 4 psychosocial exposures on condomless anal sex (CAS) among transgender women in India. A national probability-based sample of 4,607 HIV-negative transgender women completed the Indian Integrated Biological and Behavioural Surveillance survey, 2014−2015. We used linear probability regression and logistic regression to assess 2-, 3-, and 4-way interactions among 4 psychosocial exposures (physical violence, sexual violence, drug use, and alcohol use) on CAS. Overall, 27.3% reported physical and 22.3% sexual violence victimization (39.2% either physical or sexual violence), one-third (33.9%) reported frequent alcohol use and 11.5% illicit drug use. Physical violence was associated with twofold higher odds of CAS in the main effects model. Statistically significant two- and three-way interactions were identified, on both the multiplicative and the additive scales, between physical violence and drug use; physical and sexual violence; physical violence, sexual violence, and alcohol use; and physical violence, alcohol use and drug use. Physical and sexual violence victimization, and alcohol and drug use are highly prevalent and synergistically interact to increase CAS among HIV-negative transgender women in India. Targeted and integrated multilevel initiatives to improve the assessment of psychosocial comorbidities, to combat systemic transphobic violence, and to provide tailored, trauma-informed alcohol and substance use treatment services may reduce HIV risk among transgender women.
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spelling pubmed-100214662023-03-17 Syndemic violence victimization, alcohol and drug use, and HIV transmission risk behavior among HIV-negative transgender women in India: A cross-sectional, population-based study Chakrapani, Venkatesan Lakshmi, P. V. M. Newman, Peter A. Kaur, Jasvir Tsai, Alexander C. Vijin, P. P. Singh, Bhawani Kumar, Pradeep Rajan, Shobini Kumar, Rajesh PLOS Glob Public Health Research Article Transgender women globally are disproportionately burdened by HIV. Co-occurring epidemics of adverse psychosocial exposures accelerate HIV sexual risk, including among transgender women; however, studies using additive models fail to examine synergies among psychosocial conditions that define a syndemic. We examined the impact of synergistic interactions among 4 psychosocial exposures on condomless anal sex (CAS) among transgender women in India. A national probability-based sample of 4,607 HIV-negative transgender women completed the Indian Integrated Biological and Behavioural Surveillance survey, 2014−2015. We used linear probability regression and logistic regression to assess 2-, 3-, and 4-way interactions among 4 psychosocial exposures (physical violence, sexual violence, drug use, and alcohol use) on CAS. Overall, 27.3% reported physical and 22.3% sexual violence victimization (39.2% either physical or sexual violence), one-third (33.9%) reported frequent alcohol use and 11.5% illicit drug use. Physical violence was associated with twofold higher odds of CAS in the main effects model. Statistically significant two- and three-way interactions were identified, on both the multiplicative and the additive scales, between physical violence and drug use; physical and sexual violence; physical violence, sexual violence, and alcohol use; and physical violence, alcohol use and drug use. Physical and sexual violence victimization, and alcohol and drug use are highly prevalent and synergistically interact to increase CAS among HIV-negative transgender women in India. Targeted and integrated multilevel initiatives to improve the assessment of psychosocial comorbidities, to combat systemic transphobic violence, and to provide tailored, trauma-informed alcohol and substance use treatment services may reduce HIV risk among transgender women. Public Library of Science 2022-10-26 /pmc/articles/PMC10021466/ /pubmed/36962491 http://dx.doi.org/10.1371/journal.pgph.0000437 Text en © 2022 Chakrapani et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chakrapani, Venkatesan
Lakshmi, P. V. M.
Newman, Peter A.
Kaur, Jasvir
Tsai, Alexander C.
Vijin, P. P.
Singh, Bhawani
Kumar, Pradeep
Rajan, Shobini
Kumar, Rajesh
Syndemic violence victimization, alcohol and drug use, and HIV transmission risk behavior among HIV-negative transgender women in India: A cross-sectional, population-based study
title Syndemic violence victimization, alcohol and drug use, and HIV transmission risk behavior among HIV-negative transgender women in India: A cross-sectional, population-based study
title_full Syndemic violence victimization, alcohol and drug use, and HIV transmission risk behavior among HIV-negative transgender women in India: A cross-sectional, population-based study
title_fullStr Syndemic violence victimization, alcohol and drug use, and HIV transmission risk behavior among HIV-negative transgender women in India: A cross-sectional, population-based study
title_full_unstemmed Syndemic violence victimization, alcohol and drug use, and HIV transmission risk behavior among HIV-negative transgender women in India: A cross-sectional, population-based study
title_short Syndemic violence victimization, alcohol and drug use, and HIV transmission risk behavior among HIV-negative transgender women in India: A cross-sectional, population-based study
title_sort syndemic violence victimization, alcohol and drug use, and hiv transmission risk behavior among hiv-negative transgender women in india: a cross-sectional, population-based study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021466/
https://www.ncbi.nlm.nih.gov/pubmed/36962491
http://dx.doi.org/10.1371/journal.pgph.0000437
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