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Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women

BACKGROUND: Black transgender women endure pervasive polyvictimization (experiencing multiple forms of violence throughout the lifespan). Polyvictimization is associated with poor mental health. Black transgender women also face barriers in access to healthcare, but the extent that such barriers mod...

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Autores principales: Sherman, Athena D. F., Balthazar, Monique S., Daniel, Gaea, Bonds Johnson, Kalisha, Klepper, Meredith, Clark, Kristen D., Baguso, Glenda N., Cicero, Ethan, Allure, Kisha, Wharton, Whitney, Poteat, Tonia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202936/
https://www.ncbi.nlm.nih.gov/pubmed/35709158
http://dx.doi.org/10.1371/journal.pone.0269776
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author Sherman, Athena D. F.
Balthazar, Monique S.
Daniel, Gaea
Bonds Johnson, Kalisha
Klepper, Meredith
Clark, Kristen D.
Baguso, Glenda N.
Cicero, Ethan
Allure, Kisha
Wharton, Whitney
Poteat, Tonia
author_facet Sherman, Athena D. F.
Balthazar, Monique S.
Daniel, Gaea
Bonds Johnson, Kalisha
Klepper, Meredith
Clark, Kristen D.
Baguso, Glenda N.
Cicero, Ethan
Allure, Kisha
Wharton, Whitney
Poteat, Tonia
author_sort Sherman, Athena D. F.
collection PubMed
description BACKGROUND: Black transgender women endure pervasive polyvictimization (experiencing multiple forms of violence throughout the lifespan). Polyvictimization is associated with poor mental health. Black transgender women also face barriers in access to healthcare, but the extent that such barriers modify the association between polyvictimization and poor mental health has not been described using convergent mixed-methods analysis. METHODS: This convergent mixed-methods secondary analysis employs an intersectional lens and integrates two inter-related datasets to describe barriers to healthcare and the extent that such barriers modify the association between polyvictimization and mental health among Black transgender women. Investigators used survey data (n = 151 participants) and qualitative interview data (n = 19 participants) collected from Black transgender women (age 18 years and older) in Baltimore, MD and Washington, DC between 2016 and 2018. Analyses include thematic content analysis, bivariate analysis, joint display, and multivariate linear regression analysis examining mediation and moderation. RESULTS: Joint display illuminated three domains to describe how barriers to healthcare present among Black transgender women–Affordability, Accessibility, and Rapport and Continuity. Independent t-tests revealed significantly higher polyvictimization, Post Traumatic Stress Disorder (PTSD), and depression scores among participants who reported at least one barrier to healthcare (BHI) compared to those who reported no barriers. BHI significantly moderated and partially mediated the association between polyvictimization and PTSD symptom severity and BHI fully mediated the association between polyvictimization and depressive symptom severity–when accounting for age and location. DISCUSSION: Findings highlight the importance of access to healthcare in modifying the association between polyvictimization and PTSD and depression symptom severity among Black transgender women. Findings call for immediate interventions aimed at reducing barriers to healthcare and improved training for clinical providers serving Black transgender women.
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spelling pubmed-92029362022-06-17 Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women Sherman, Athena D. F. Balthazar, Monique S. Daniel, Gaea Bonds Johnson, Kalisha Klepper, Meredith Clark, Kristen D. Baguso, Glenda N. Cicero, Ethan Allure, Kisha Wharton, Whitney Poteat, Tonia PLoS One Research Article BACKGROUND: Black transgender women endure pervasive polyvictimization (experiencing multiple forms of violence throughout the lifespan). Polyvictimization is associated with poor mental health. Black transgender women also face barriers in access to healthcare, but the extent that such barriers modify the association between polyvictimization and poor mental health has not been described using convergent mixed-methods analysis. METHODS: This convergent mixed-methods secondary analysis employs an intersectional lens and integrates two inter-related datasets to describe barriers to healthcare and the extent that such barriers modify the association between polyvictimization and mental health among Black transgender women. Investigators used survey data (n = 151 participants) and qualitative interview data (n = 19 participants) collected from Black transgender women (age 18 years and older) in Baltimore, MD and Washington, DC between 2016 and 2018. Analyses include thematic content analysis, bivariate analysis, joint display, and multivariate linear regression analysis examining mediation and moderation. RESULTS: Joint display illuminated three domains to describe how barriers to healthcare present among Black transgender women–Affordability, Accessibility, and Rapport and Continuity. Independent t-tests revealed significantly higher polyvictimization, Post Traumatic Stress Disorder (PTSD), and depression scores among participants who reported at least one barrier to healthcare (BHI) compared to those who reported no barriers. BHI significantly moderated and partially mediated the association between polyvictimization and PTSD symptom severity and BHI fully mediated the association between polyvictimization and depressive symptom severity–when accounting for age and location. DISCUSSION: Findings highlight the importance of access to healthcare in modifying the association between polyvictimization and PTSD and depression symptom severity among Black transgender women. Findings call for immediate interventions aimed at reducing barriers to healthcare and improved training for clinical providers serving Black transgender women. Public Library of Science 2022-06-16 /pmc/articles/PMC9202936/ /pubmed/35709158 http://dx.doi.org/10.1371/journal.pone.0269776 Text en © 2022 Sherman 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
Sherman, Athena D. F.
Balthazar, Monique S.
Daniel, Gaea
Bonds Johnson, Kalisha
Klepper, Meredith
Clark, Kristen D.
Baguso, Glenda N.
Cicero, Ethan
Allure, Kisha
Wharton, Whitney
Poteat, Tonia
Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women
title Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women
title_full Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women
title_fullStr Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women
title_full_unstemmed Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women
title_short Barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among Black transgender women
title_sort barriers to accessing and engaging in healthcare as potential modifiers in the association between polyvictimization and mental health among black transgender women
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202936/
https://www.ncbi.nlm.nih.gov/pubmed/35709158
http://dx.doi.org/10.1371/journal.pone.0269776
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