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Published Online: 14 January 2020

Role of Structural Marginalization, HIV Stigma, and Mistrust on HIV Prevention and Treatment Among Young Black Latinx Men Who Have Sex with Men and Transgender Women: Perspectives from Youth Service Providers

Publication: AIDS Patient Care and STDs
Volume 34, Issue Number 1

Abstract

Young black and Latinx men who have sex with men (YBLMSM) and transgender women (YBLTW) are disproportionately impacted by HIV. Structural and social marginalization, the social barriers, and structures that unevenly distribute benefits and burdens to different groups, may contribute to inability for youth to access prevention and treatment care services. Yet, few reports have examined the community and health care experiences of social marginalization among youth service providers who have multiple roles in the community (i.e., serve as a service provider and are a member or prior member of the YBLMSM and YBLTW population). Eighteen key informants (KIs), defined as youth, young adults, or adults who were members of or connected to the YBLMSM and young black and Latinx transgender (YBLTG) community, participated in a one-time, face-to-face, or telephone key informant interview (KII) lasting ∼45 min. KIs were defined as youth service providers because they described working with the target population and either being a member of or closely connected to the target population. KIs described key themes related to marginalization: lack of competent care among health care providers and both clinical and community spaces that left out key populations. HIV stigma and medical mistrust continues to create a barrier to care in this population and for interventions to be effective interventions will need to use an intersectional approach that simultaneously address all identities, and the social and structural needs of youth.

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cover image AIDS Patient Care and STDs
AIDS Patient Care and STDs
Volume 34Issue Number 1January 2020
Pages: 7 - 15
PubMed: 31944853

History

Published online: 14 January 2020
Published in print: January 2020

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Renata Arrington-Sanders [email protected]
Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
Kimberly Hailey-Fair
Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
Andrea L. Wirtz
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Anthony Morgan
Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
Durryle Brooks
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Marne Castillo
The Adolescent Initiative, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Connie Trexler
Adolescent Clinical Research, Burgess Clinic, Children's National Medical Center, Washington, District of Columbia.
Jennafer Kwait
Whitman-Walker Health, Washington, District of Columbia.
Nadia Dowshen
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Noya Galai
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Chris Beyrer
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
David Celentano
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Notes

Address correspondence to: Renata Arrington-Sanders, MD, MPH, ScM, Division of General Pediatrics & Adolescent Medicine, 200 North Wolfe Street, Baltimore, MD 21287 [email protected]

Author Disclosure Statement

No competing financial interests exist.

Funding Information

This work was supported by the National Institute of Drug Abuse (NIDA) R01DA043089.

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