El uso y no uso del condón en mujeres trans de Colombia: un análisis cualitativo desde el modelo IMB
DOI:
https://doi.org/10.11606/s1518-8787.2022056004145Palavras-chave:
Mujeres, Personas Transgénero, Sexo sin proteción, Minorías Sexuales y de Género, psicología, Investigación CualitativaResumo
OBJETIVO Analizar las razones del uso y no uso del condón que tienen las mujeres trans de Colombia desde el modelo de información, motivación y habilidades conductuales (IMB por sus siglas en inglés). MÉTODO Estudio cualitativo en el cual se llevó a cabo el análisis de proceso iterativo. Se realizó un grupo focal de manera presencial y entrevistas a profundidad de manera virtual. RESULTADOS Primer estudio llevado a cabo en Colombia sobre el uso del preservativo en mujeres trans bajo el modelo IMB. En el componente información se identifica que la educación sexual tradicional no tiene un impacto positivo. Respecto a lo motivacional, se destaca la importancia del apoyo y acompañamiento familiar y de las organizaciones de base comunitaria para motivar al cuidado de la salud sexual y el uso del preservativo. Con relación a las habilidades conductuales, se analiza que la desconfianza hacia la pareja sexual y la adquisición de los preservativos promueven su uso. CONCLUSIONES Se hace importante la creación de espacios de educación sexual realizados por y para la población LGBTIQ, acompañados por el saber médico de los centros de salud, para impactar de manera positiva la salud sexual de mujeres trans; se motiva a la realización de estudios con parejas sexuales de mujeres trans para conocer las razones por las cuales solicitan el no uso del preservativo.
Referências
Platero Méndez RL. Trans*exualidades: acompañamientos, factores de salud y recursos educativos. Barcelona (ES): Edicions Bellaterra; 2015.
Rocha ABM, Barros C, Generoso IP, Bastos FI, Veras MA. HIV continuum of care among trans women and travestis living in São Paulo, Brazil. Rev Saude Publica. 2020;54:118. https://doi.org/10.11606/s1518-8787.2020054002374
Skaathun B, Pines HA, Patterson TL, Semple SJ, Pekar J, Harvey-Vera A, et al. Recent HIV Infection among men who have sex with men and transgender women in Tijuana. Rev Saude Publica. 2020;54:82. https://doi.org/10.11606/s1518-8787.2020054002179
Fontenot HB, Cahill SR, Wang T, Geffen S, White BP, Reisner S, et al. Transgender youth experiences and perspectives related to HIV preventive services. Pediatrics. 2020;145(4):e20192204. https://doi.org/10.1542/peds.2019-2204
Mueses-Marín HF, Tello-Bolívar IC, Galindo-Orrego MI, Galindo-Quintero J. Perceptions about sexual risk, HIV and HIV-testing in Cali, Colombia. Colomb Med (Cali). 2018;49(2):139-47. https://doi.org/10.25100/cm.v49i2.2945
Sheinfil AZ, Giguere R, Dolezal C, Lopes-Rios J, Iribarren S, Brown W III, et al. Information and motivation predict HIV-serostatus among a population of high-risk men and transgender women who have sex with men. AIDS Behav. 2020;24:2863-71. https://doi.org/10.1007/s10461-020-02835-z
Wang H, Chang R, Shen Q, Tsamlag L, Zhang X, Shi Y, et al. Information-Motivation-Behavioral Skills model of consistent condom use among transgender women in Shenyang, China. BMC Public Health. 2020;20:394. https://doi.org/10.1186/s12889-020-08494-y
Cuenta de Alto Costo. VIH Sida en Colombia, retos y apuestas en salud. Bogotá (CO): CAC; 2020 [citado 29 may 2021]. Disponible en: https://cuentadealtocosto.org/site/vih/vih-sida-en-colombia-retos-y-apuestas-en-salud/
Del Romero J, García-Pérez JN, Espasa-Soley M. Prevention and treatment of sexually transmitted infections in high-risk individuals, including patients with HIV infection. Enferm Infecc Microbiol Clin (Engl Ed). 2019;37(2):117-26. https://doi.org/10.1016/j.eimc.2018.11.008
Operario D, Gamarel KE, Iwamoto M, Susuki S, Suico S, Darbes L, et al. Couples-focused prevention program to reduce HIV risk among transgender women and their primary male partners: feasibility and promise of the couples HIV intervention program. AIDS Behav. 2017;21:2452-63. https://doi.org/10.1007/s10461-016-1462-2
Yi S, Plant A, Tuot S, Mun P, Chhim S, Chann N, et al. Factors associated with condom use with non-commercial partners among sexually-active transgender women in Cambodia: findings from a national survey using respondent-driven sampling. BMC Public Health. 2019;19:326. https://doi.org/10.1186/s12889-019-6656-x
Ayer A, Perez-Brumer A, Segura ER, Chavez-Gomez S, Fernandez R, Arroyo C, et al. Let’s talk about sex: the impact of partnership contexts on communication about hiv serostatus and condom use among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. AIDS Behav. 2021;25:2139-53. https://doi.org/10.1007/s10461-020-03144-1
Satcher MF, Segura ER, Silva-Santisteban A, Sanchez J, Lama JR, Clark JL. Partner-level factors associated with insertive and receptive condomless anal intercourse among transgender women in Lima, Peru. AIDS Behav. 2017;21:2439-51. https://doi.org/10.1007/s10461-016-1503-x
Parsons JT, Antebi-Gruszka N, Millar BM, Cain D, Gurung S. Syndemic conditions, HIV transmission risk behavior, and transactional sex among transgender women. AIDS Behav. 2018;22(7):2056-67. https://doi.org/10.1007/s10461-018-2100-y
Moayedi-Nia S, Taheri L, Hosseini Rouzbahani N, Rasoolinejad M, Nikzad R, Ardebili ME, et al HIV prevalence and sexual behaviors among transgender women in Tehran, Iran. AIDS Behav. 2019;23:1590-3. https://doi.org/10.1007/s10461-018-02380-w
Rongkavilit C, Naar-King S, Kaljee LM, Panthong A, Koken JA, Bunupuradah T, et al. Applying the information-motivation-behavioral skills model in medication adherence among Thai youth living with HIV: a qualitative study. AIDS Patient Care STDS. 2010;24(12):787-94. https://doi.org/10.1089/apc.2010.0069
Lemieux AF, Fisher JD, Pratto F. A music-based HIV prevention intervention for urban adolescents. Health Psychol. 2008;27(3):349-57. https://doi.org/10.1037/0278-6133.27.3.349
Singh S. Study of the effect of information, motivation and behavioural skills (IMB) intervention in changing AIDS risk behaviour in female university students. AIDS Care. 2003;15(1):71-6. https://doi.org/10.1080/095401202100039770
Fisher JD, Fisher WA, Shuper PA. The information-motivation-behavioral skills model of HIV preventive behavior. In: DiClemente RJ, Crosby RA, Kelger MC, editors. Emerging theories in health promotion practice and research. San Francisco, CA: Jossey Bass/Wiley; 2009. p. 21-64.
Gerend MA, Madkins K, Crosby S, Korpak AK, Phillips GL 2nd, Bass M, et al. A qualitative analysis of young sexual minority men's perspectives on human papillomavirus vaccination. LGBT Health. 2019;6(7):350-6. https://doi.org/10.1089/lgbt.2019.0086
Fisher JD, Fisher WA, Misovich SJ, Kimble DL, Malloy TE. Changing AIDS risk behavior: effects of an intervention emphasizing AIDS risk reduction information, motivation, and behavioral skills in a college student population. Health Psychol. 1996;15(2):114-23. https://doi.org/10.1037//0278-6133.15.2.114
Fisher JD, Fisher WA, Amico KR, Harman JJ. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol. 2006;25(4):462-73. https://doi.org/10.1037/0278-6133.25.4.462
DeCuir-Gunby JT, Marshall PL, McCulloch AW. Developing and using a codebook for the analysis of interview data: an example from a professional development research project. Field Methods. 2011;23:136-55. https://doi.org/10.1177/1525822X10388468
Yan GW, Bernard HR. Techniques to identify themes. Field Methods. 2003;15(1):85-109. https://doi.org/10.1177/1525822X02239569
Andrzejewski J, Pampati S, Johns MM, Sheremenko G, Lesesne C, Rasberry CN. Sexual behaviors, referral to sexual health services, and use of sexual health services among transgender high school students. J Sch Health. 2020;90(5):349-57. https://doi.org/10.1111/josh.12880
Poteat T, Malik M, Scheim A, Elliott A. HIV prevention among transgender populations: knowledge gaps and evidence for action. Curr HIV/AIDS Rep. 2017;14:141-52. https://doi.org/10.1007/s11904-017-0360-1
Minor Peters M. 'They wrote "gay" on her file': transgender Ugandans in HIV prevention and treatment. Cult Health Sex. 2016;18(1):84-98. https://doi.org/10.1080/13691058.2015.1060359
Khalid H, Martin, EG. Relationship between network operators and risky sex behaviors among female versus transgender commercial sex workers in Pakistan. AIDS Care. 2019;31(6):767-76. https://doi.org/10.1080/09540121.2018.1557317
Ferreira Jr S, Francisco PMSB, Nogueira PA. [Profile of transvestites and transgender women: tuberculosis and HIV/AIDS in the city of São Paulo]. Rev Panam Salud Publica. 2016;40(6):410-7. Portuguese.
Turner CM, Ahern J, Santos GM, Arayasirikul S, Wilson EC. Parent/caregiver responses to gender identity associated with HIV-related sexual risk behavior among young trans women in San Francisco. J Adolesc Health. 2019;65(4):491-7. https://doi.org/10.1016/j.jadohealth.2019.04.032
Smart BD, Mann-Jackson L, Alonzo J, Tanner AE, Garcia M, Aviles LR, et al. Transgender women of color in the U.S. South: a qualitative study of social determinants of health and healthcare perspectives. Int J Transgend Health. 2020 Dec 17. Epub ahead of print. https://doi.org/10.1080/26895269.2020.1848691
Maliya S, Zul AR, Irwan MS, Samsul D, Zakiah MS, Rafidah HM. Mak Nyahs in Malaysia: does HIV/AIDS knowledge really reduce HIV-related risk behaviours? IMJM Int Med J Malaysia. 2018;17(3). https://doi.org/10.31436/imjm.v17i3.241
Gama A, Martins MRO, Mendão L, Barros H, Dias S. HIV Infection, risk factors and health services use among male-to-female transgender sex workers: a cross-sectional study in Portugal. AIDS Care. 2018;30(1):1-8. https://doi.org/10.1080/09540121.2017.1332736
Ávila MM, Farias MSR, Fazzi L, Romero M, Reynaga E, Marone R, et al. High frequency of illegal drug use influences condom use among female transgender sex workers in Argentina: impact on HIV and syphilis infections. AIDS Behav. 20217;21(7):2059-68. https://doi.org/10.1007/s10461-017-1766-x
Poteat T, Wirtz AL, Radix A, Borquez A, Silva-Santisteban A, Deutsch MB. HIV risk and preventive interventions in transgender women sex workers. 2015;385(9964):274-86. https://doi.org/10.1016 / S0140-6736 (14) 60833-3
Urrea Giraldo F, La Furcia A. Pigmentocracia dei deseo en el mercado sexual Trans de Cali, Colombia. Sex Salud Soc (Rio J). 2014(16):121-52. https://doi.org/10.1590/S1984-64872014000100007
Lucero Posso J, La Furcia A. El fantasma de la puta-peluquera: género, trabajo y estilistas trans en Cali y San Andrés Isla, Colombia. Sex Salud Soc. 2016;(24):172-214. https://doi.org/10.1590/1984-6487.sess.2016.24.08.a
Fontanari AMV, Rovaris DL, Costa AB, Pasley A, Cupertino RB, Soll BMB, et al. Childhood maltreatment linked with a deterioration of psychosocial outcomes in adult life for. Southern Brazilian transgender women. J Inmigr Minor Health. 2018;20:33-43. https://doi.org/10.1007/s10903-016-0528-6
Jesus JG, Belden CM, Huynh HV, Malta M, LeGrand S, Kaza VGK, et al. Mental health and challenges of transgender women: a qualitative study in Brazil and India. Int J Transgend Health. 2020;21(4):418-30. https://doi.org/10.1080/26895269.2020.1761923
Saura S, Jorquera V, Rodríguez D, Mascort C, Castellà I, García J. Percepción del riesgo de infecciones de transmisión sexual/VIH en jóvenes desde una perspectiva de género. Aten Primaria. 2019;52(3):218-9. https://doi.org/10.1016/j.aprim.2019.07.003
Van Schuylenbergh J, Motmans J, Defreyne J, Somers A, T’Sjoen G. Sexual health, transition-related risk behavior and need for health care among transgender sex workers. Int J Transgend. 2019;20(4):388-402. https://doi.org/10.1080/15532739.2019.1617217
Beckwith CG, Kuo I, Fredericksen RJ, Brinkley-Rubinstein L, Cunningham WE, Springer SA, et al. Risk behaviors and HIV care continuum outcomes among criminal justice-involved HIV-infected transgender women and cisgender men: data from the Seek, Test, Treat, and Retain Harmonization Initiative. PloS One. 2018;13(5):e0197730. https://doi.org/10.1371/journal.pone.0197730
Druckler S, Rooijen MS, Vries HJC. Substance use and sexual risk behavior among male and transgender women sex workers at the Prostitution Outreach Center in Amsterdam, the Netherlands. Sex Transm Dis. 2020;47(2):114-21. https://doi.org/10.1097/OLQ.0000000000001096
Haley SG, Tordoff DM, Kantor AZ, Crouch JM, Ahrens KR. Sex education for transgender and non-binary youth: previous experiences and recommended content. J Sex Med. 2019;16(11):1834-48. https://doi.org/10.1016/j.jsxm.2019.08.009
Brown C, Eisenberg ME, McMorris BJ, Sieving RE. Parents matter: associations between parent connectedness and sexual health indicators among transgender and gender-diverse adolescents. Perspect Sex Reprod Health. 2020;52(4):265-73. https://doi.org/10.1363/psrh.12168
Balán IC, Lopez-Rios J, Dolezal C, Rael CT, Lentz C. Low sexually transmissible infection knowledge, risk perception and concern about infection among men who have sex with men and transgender women at high risk of infection. Sex Health. 2019;16(6):580-6. https://doi.org/10.1071/SH18238
Rasberry CN, Morris E, Lesesne, CA, Kroupa E, Topete P, Carver, et al. Communicating with school nurses about sexual orientation and sexual health: perspectives of teen young men who have sex with men. J Sch Nurs. 2015;31(5):334-44. https://doi.org/10.1177/1059840514557160
Baams L, Dubas JS, Aken MAG. Comprehensive sexuality education as a longitudinal predictor of LGBTQ name-calling and perceived willingness to intervene in school. J Youth Adolesc. 2017;46(5):931-42. https://doi.org/10.1007/s10964-017-0638-z
Moncayo Quevedo JE, Pérez-Arizabaleta MM, Reyes Sevillano W, Orejuela J. Salud sexual y subjetividad: sentidos construidos alrededor del uso y no uso del condón. In: Moncayo JE, Orejuela J, Reyes Sevillano W, Pérez Arizabaleta MDM. Salud, subjetividad y estudios cualitativos. Aproximaciones a la salud sexual, física y mental. Cali (CO): Editorial Universidad Santiago de Cali; Universidad EAFIT; Universidad Antonio Nariño; 2022. p. 67-215.
Ministerio del Interior (CO). Decreto Nº 762 del 7 de Mayo de 2018. Por el cual se adiciona un capítulo al Título 4 a la Parte 4, del Libro 2, del Decreto 1066 de 2015, Único Reglamentario del Sector Interior, para adoptar la Política Pública para la garantía del ejercicio efectivo de los derechos de las personas que hacen parte de los sectores sociales LGBTI y de personas con orientación sexual e identidades de género diversas. Bogotá (CO); 2018 [citado 19 jun 2021]. Disponible en: http://es.presidencia.gov.co/normativa/normativa/DECRETO%20762%20DEL%2007%20DE%20MAYO%20DE%202018.pdf
Pérez Arizabaleta M, Acuña Lara YA, Moncayo Quevedo JE, Jiménez Ruiz MC, Reyes Sevillano WH. Por el placer y la vida. Cartilla de salud sexual, prácticas y formas de protección. Bogotá (CO): Universidad Antonio Nariño; 2021 [citado 19 jun 2021]. Disponible en: http://repositorio.uan.edu.co/bitstream/123456789/4784/1/Cartilla%20Sexualidad%20Completa.pdf
Bao A, Colby DJ, Trang T, Le BQ, Dinh TD, Nguyen QH, et al. Correlates of HIV testing among transgender women in Ho Chi Minh, Vietnam. AIDS Behav. 2016;20 Suppl 3:S371-8. https://doi.org/10.1007/s10461-016-1574-8
Degtyar A, George PE, Mallma P, Diaz DA, Cárcamo C, García PJ, et al. Sexual risk behavior and HIV testing and status among male and transgender women sex workers and their clients in Lima, Peru. Int J Sex Health. 2018;30(1):81-91. https://doi.org/10.1080/19317611.2018.1429514
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2022 Jorge Eduardo Moncayo Quevedo, María Del Mar Pérez-Arizabaleta, Wilmar Hernán Reyes Sevillano
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
