Screening for gender-based violence and other forms of stigma and discrimination among MSM and transgendered persons: a synthesis and review of relevant literature
Background: Violence experienced by populations most-at-risk for HIV, MSM and transgendered persons, can be characterized as gender-based. Viewed in this framework, hypotheses on sources of vulnerability to HIV by MSM and transgenders, as well as lessons on the ways that health programs can address that vulnerability, can be taken from the field of violence against women. The literature on GBV faced by transgenders and MSM and its links to HIV vulnerability was synthesized in a literature review and analysis. Literature on programs that seek to address GBV (for women and MSM or transgenders) in health settings was also reviewed and summarized.
Methods: This review was performed using sources identified on POPLINE, MEDLINE, the Cochrane Database and Ingentaconnect, a review of bibliographies of relevant literature reviews, and searching over 20 organizational websites. The following search terms were used: screening, identification, gender-based violence, intimate partner violence, domestic violence, violence, HIV, sex worker, prostitute, men who have sex with men and transgender. Specialists from organizations of TG and MSM were consulted.
Results: Although few studies were identified that highlight the intersection between GBV against transgendered persons and MSM and HIV vulnerability, the extent of violence and the impact on vulnerability was important. For GBV against women, screening for intimate partner violence is the primary evaluated response from the health setting, and there are important lessons to be learned from those experiences for addressing GBV against MSM and transgendered persons.
Conclusions: Based on the studies identified, the authors elaborated an ecological model (taken from the field of youth and intimate partner violence) to conceptualize violence experienced by transgendered persons and MSM, its impact on HIV vulnerability and interventions to address it. Based on this work a pilot screening intervention was designed to further explore GBV and HIV vulnerability and develop collaborative interventions.
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