Browsing by Author "Marshall, Brandon"

Now showing 1 - 4 of 4
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    Acceptability of HIV Pre-exposure Prophylaxis (PrEP) Among People Who Inject Drugs (PWID) in a Canadian Setting
    (2015) Escudero, Daniel; Kerr, Thomas; Wood, Evan; Nguyen, Paul; Lurie, Mark; Sued, Omar; Marshall, Brandon
    A recent clinical trial provided evidence that pre-exposure prophylaxis (PrEP) has the potential to prevent HIV infection among people who inject drugs (PWID). We examined willingness to use PrEP among HIV-negative PWID in Vancouver, Canada (n = 543) to inform PrEP implementation efforts. One third (35.4 %) expressed willingness to use PrEP, with adjusted models indicating that younger age, no regular employment, requiring help injecting, engaging in sex work, and reporting multiple recent sexual partners were positively associated with willingness to use PrEP. Although willingness to use PrEP was low, PrEP was acceptable to some PWID at heightened risk for HIV infection.
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    Inclusion of trans women in pre-exposure prophylaxis trials: a review.
    (2015) Escudero, Daniel; Kerr, Thomas; Operario, Don; Socias, Maria E.; Sued, Omar; Marshall, Brandon
    Trans women are at high-risk of HIV infection. We conducted a review to determine the extent to which trans women were eligible for inclusion in and enrolled into pre-exposure prophylaxis (PrEP) efficacy trials. Out of seven trials analyzing PrEP efficacy, we found that trans women comprised only 1.2% of one trial, and 0.2% of total trial enrollments. Although an additional PrEP trial to determine efficacy among trans women may not be warranted, further research is needed to determine the effectiveness of PrEP in this marginalized population, through observational and feasibility studies. These studies should focus on unique barriers that trans women may experience while obtaining access to PrEP, such as gender discrimination, transphobia, and violence.
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    Prevalence and correlates of suicidal behavior among transgender women in Argentina.
    (2016-2) Marshall, Brandon; Socias, Maria E.; Kerr, Thomas; Zalazar, Virginia; Sued, Omar; Aristegui, Ines
    This study examined the lifetime prevalence and correlates of attempted suicide among transgender persons in Argentina. Data were derived from a nation-wide, cross-sectional survey conducted in 2013. We assessed individual, social, and structural correlates of reporting a history of attempting suicide using logistic regression. Among 482 participants, the median age was 30, 91% identified as transwomen, and 32% resided in the Buenos Aires metropolitan area. A lifetime suicide attempt was reported by 159 (33%), among whom the median age at first attempt was 17. In a multivariate model, internalized stigma was positively associated with a history of suicidal behavior, while participants with stable housing had reduced odds of prior suicide attempt(s). These findings suggest that reducing stigma and mitigating structural vulnerabilities (through, for example, the enactment and enforcement of laws that prohibit discrimination based on gender identity to ensure equitable access to housing) could be effective targets for intervention to reduce suicide attempts among transgender individuals in Argentina.
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    Towards Full Citizenship: Correlates of Engagement with the Gender Identity Law among Transwomen in Argentina
    (2014-8) Socias, Maria E.; Marshall, Brandon; Aristegui, Ines; Zalazar, Virginia; Romero, Marcela; Sued, Omar; Kerr, Thomas
    Introduction In May 2012, Argentina passed its “Gender Identity” Law, which aimed to address the legal invisibility, discrimination and marginalization that transgender individuals have historically faced. The aim of this study was to explore factors associated with engagement with the Gender Identity Law among transwomen living in Argentina. Methods Data were derived from a 2013 nationwide, cross-sectional study involving transwomen in Argentina. Using multivariate logistic regression, we assessed the prevalence and factors associated with acquiring a gender-congruent identity card within the first 18 months of enactment of the Gender Identity Law. Results Among 452 transwomen, 260 (57.5%) reported that they had obtained a new gender-congruent identity card. In multivariate analysis, factors positively associated with acquiring a new ID were: previously experiencing discrimination by healthcare workers (adjusted odd ratio [aOR] = 2.01, 95% CI: 1.27–3.20); having engaged in transition procedures (aOR = 3.06, 95% CI: 1.58–5.93); and having a job other than sex work (aOR = 1.81, 95% CI: 1.06–3.10). Foreign born transwomen were less likely to have obtained a new ID (aOR = 0.14, 95% CI: 0.06–0.33). Conclusions More than half of transwomen in our sample acquired a new gender-congruent ID within the first 18 months of enactment of the Gender Identity Law. However, access to and uptake of this right has been heterogeneous. In particular, our findings suggest that the most empowered transwomen may have been among the first to take advantage of this right. Although educational level, housing conditions, HIV status and sex work were not associated with the outcome, foreign-born status was a strong negative correlate of new ID acquisition. Therefore, additional efforts should be made in order to ensure that benefits of this founding policy reach all transwomen in Argentina.