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Experiences of gender-based violence among female sex workers, men who have sex with men, and transgender women in Latin America and the Caribbean: a qualitative study to inform HIV programming.
BMC Int Health Hum Rights. 2019 03 05; 19(1):9.BI

Abstract

BACKGROUND

Female sex workers, MSM, and transgender women-collectively referred to as key populations (KPs)-are disproportionately affected by gender-based violence (GBV) and HIV, yet little is known about the violence they face, its gender-based origins, and responses to GBV. The purpose of this study was to understand the nature and consequences of GBV experienced, to inform HIV policies and programming and to help protect KPs' human rights.

METHODS

Using a participatory approach, FSWs, MSM, and transgender women in Barbados, El Salvador, Trinidad and Tobago, and Haiti conducted 278 structured interviews with peers to understand their experiences of and responses to GBV. Responses to open-ended questions were coded in NVivo and analyzed using an applied thematic analysis.

RESULTS

Nearly all participants experienced some form of GBV. Emotional and economic GBV were the most commonly reported but approximately three-quarters of participants reported sexual and physical GBV and other human rights violations. The most common settings for GBV were at home, locations where sex work took place such as brothels, bars and on the street; public spaces such as parks, streets and public transport, health care centers, police stations and-for transgender women and MSM-religious settings and schools. The most common perpetrators of violence included: family, friends, peers and neighbors, strangers, intimate partners, sex work clients and other sex workers, health care workers, police, religious leaders and teachers. Consequences included emotional, physical, and sexual trauma; lack of access to legal, health, and other social services; and loss of income, employment, housing, and educational opportunities. Though many participants disclosed experiences of GBV to friends, colleagues and family, they rarely sought services following violence. Furthermore, less than a quarter of participants believed that GBV put them at risk of HIV.

CONCLUSIONS

Our study found that across the four study countries, FSWs, MSM, and transgender women experienced GBV from state and non-state actors throughout their lives, and much of this violence was directly connected to rigid and harmful gender norms. Through coordinated interventions that address both HIV and GBV, this region has the opportunity to reduce the national burden of HIV while also promoting key populations' human rights.

Authors+Show Affiliations

FHI 360, 359 Blackwell Street, Durham, NC, 27707, USA. eevens@fhi360.org.FHI 360, 359 Blackwell Street, Durham, NC, 27707, USA.United Nations Development Programme, Panama City, Panama.United Nations Development Programme, Panama City, Panama.FHI 360, 359 Blackwell Street, Durham, NC, 27707, USA.FHI 360, 359 Blackwell Street, Durham, NC, 27707, USA.FHI 360, 359 Blackwell Street, Durham, NC, 27707, USA.FHI 360, 359 Blackwell Street, Durham, NC, 27707, USA.University of the West Indies, Mona Campus, Kingston, Jamaica.LINKAGES Project, FHI 360, Port-au-Prince, Haiti.United Nations Development Programme, San Salvador, El Salvador.United Nations Development Programme, San Salvador, El Salvador.Centre for Health Economics, The University of the West Indies St. Augustine Campus, St Augustine, Trinidad and Tobago.Asociación Diké de Hombres y Mujeres Transgénero y LGBTI+, San Salvador, El Salvador.FHI 360, 359 Blackwell Street, Durham, NC, 27707, USA.Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.FHI 360, 359 Blackwell Street, Durham, NC, 27707, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30832664

Citation

Evens, Emily, et al. "Experiences of Gender-based Violence Among Female Sex Workers, Men Who Have Sex With Men, and Transgender Women in Latin America and the Caribbean: a Qualitative Study to Inform HIV Programming." BMC International Health and Human Rights, vol. 19, no. 1, 2019, p. 9.
Evens E, Lanham M, Santi K, et al. Experiences of gender-based violence among female sex workers, men who have sex with men, and transgender women in Latin America and the Caribbean: a qualitative study to inform HIV programming. BMC Int Health Hum Rights. 2019;19(1):9.
Evens, E., Lanham, M., Santi, K., Cooke, J., Ridgeway, K., Morales, G., Parker, C., Brennan, C., de Bruin, M., Desrosiers, P. C., Diaz, X., Drago, M., McLean, R., Mendizabal, M., Davis, D., Hershow, R. B., & Dayton, R. (2019). Experiences of gender-based violence among female sex workers, men who have sex with men, and transgender women in Latin America and the Caribbean: a qualitative study to inform HIV programming. BMC International Health and Human Rights, 19(1), 9. https://doi.org/10.1186/s12914-019-0187-5
Evens E, et al. Experiences of Gender-based Violence Among Female Sex Workers, Men Who Have Sex With Men, and Transgender Women in Latin America and the Caribbean: a Qualitative Study to Inform HIV Programming. BMC Int Health Hum Rights. 2019 03 5;19(1):9. PubMed PMID: 30832664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Experiences of gender-based violence among female sex workers, men who have sex with men, and transgender women in Latin America and the Caribbean: a qualitative study to inform HIV programming. AU - Evens,Emily, AU - Lanham,Michele, AU - Santi,Karin, AU - Cooke,Juana, AU - Ridgeway,Kathleen, AU - Morales,Giuliana, AU - Parker,Caleb, AU - Brennan,Claire, AU - de Bruin,Marjan, AU - Desrosiers,Pavel Chladni, AU - Diaz,Xenia, AU - Drago,Marta, AU - McLean,Roger, AU - Mendizabal,Modesto, AU - Davis,Dirk, AU - Hershow,Rebecca B, AU - Dayton,Robyn, Y1 - 2019/03/05/ PY - 2017/11/06/received PY - 2019/01/09/accepted PY - 2019/3/6/entrez PY - 2019/3/6/pubmed PY - 2019/8/14/medline KW - Gender KW - Gender-based violence KW - HIV KW - Human rights KW - Key populations KW - Latin American and the Caribbean KW - Men who have sex with men KW - Qualitative KW - Sex workers KW - Transgender women SP - 9 EP - 9 JF - BMC international health and human rights JO - BMC Int Health Hum Rights VL - 19 IS - 1 N2 - BACKGROUND: Female sex workers, MSM, and transgender women-collectively referred to as key populations (KPs)-are disproportionately affected by gender-based violence (GBV) and HIV, yet little is known about the violence they face, its gender-based origins, and responses to GBV. The purpose of this study was to understand the nature and consequences of GBV experienced, to inform HIV policies and programming and to help protect KPs' human rights. METHODS: Using a participatory approach, FSWs, MSM, and transgender women in Barbados, El Salvador, Trinidad and Tobago, and Haiti conducted 278 structured interviews with peers to understand their experiences of and responses to GBV. Responses to open-ended questions were coded in NVivo and analyzed using an applied thematic analysis. RESULTS: Nearly all participants experienced some form of GBV. Emotional and economic GBV were the most commonly reported but approximately three-quarters of participants reported sexual and physical GBV and other human rights violations. The most common settings for GBV were at home, locations where sex work took place such as brothels, bars and on the street; public spaces such as parks, streets and public transport, health care centers, police stations and-for transgender women and MSM-religious settings and schools. The most common perpetrators of violence included: family, friends, peers and neighbors, strangers, intimate partners, sex work clients and other sex workers, health care workers, police, religious leaders and teachers. Consequences included emotional, physical, and sexual trauma; lack of access to legal, health, and other social services; and loss of income, employment, housing, and educational opportunities. Though many participants disclosed experiences of GBV to friends, colleagues and family, they rarely sought services following violence. Furthermore, less than a quarter of participants believed that GBV put them at risk of HIV. CONCLUSIONS: Our study found that across the four study countries, FSWs, MSM, and transgender women experienced GBV from state and non-state actors throughout their lives, and much of this violence was directly connected to rigid and harmful gender norms. Through coordinated interventions that address both HIV and GBV, this region has the opportunity to reduce the national burden of HIV while also promoting key populations' human rights. SN - 1472-698X UR - https://www.unboundmedicine.com/medline/citation/30832664/Experiences_of_gender_based_violence_among_female_sex_workers_men_who_have_sex_with_men_and_transgender_women_in_Latin_America_and_the_Caribbean:_a_qualitative_study_to_inform_HIV_programming_ L2 - https://bmcinthealthhumrights.biomedcentral.com/articles/10.1186/s12914-019-0187-5 DB - PRIME DP - Unbound Medicine ER -