P4.05 Migration and acculturation: understanding transgender network socialisation patterns in lima, peru (original) (raw)
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Sexual and Reproductive Health Matters, 2023
This paper presents the results of formative research conducted from January to June 2020 in the Department of Atlántico, Caribbean region of Colombia, whose findings were used as inputs to design the national strategy for comprehensive sexuality education (CSE) outside school – Tírala Plena – including its curriculum. This is within the framework of the multi-country project coordinated by UNFPA and WHO aimed at generating evidence on the role of facilitators in the delivery of CSE in non-school contexts. The research was carried out in four municipalities in northern Colombia, in rural and marginal urban contexts with conditions of vulnerability for the adolescent population, including a strong presence of migrant populations from Venezuela. A total of 150 male and female adolescents ages 10–17 participated in the formative research. Workshops such as patchwork quilt, body mapping and talking maps were used as methods to gather information. The groups were divided by sex and age (10–13 years old and 14–17 years old). Knowledge, attitudes and social norms regarding adolescent pregnancy, sexually transmitted infections, including human immunodeficiency virus, and gender-based violence, were identified in adolescents (schooled and not schooled, but with minimal or no access to CSE). All of the above enabled us to establish a set of recommendations for the strengthening of the CSE strategy Tírala plena.
PLOS ONE
Objectives HIV prevalence and incidence are higher among key populations including Men who have Sex with Men (MSM) and transgender women in low and middle income countries, when compared to the general population. Despite World Health Organisation guidelines on the provision of services to key populations recommending an evidence-based, culturally relevant and rights-based approach, uptake of HIV services in many resource-limited and rights-constrained settings remains low. Mé decins Sans Frontières (MSF) has been offering health services for MSM and transgender women in Beira, Mozambique since 2014 using a peer-educator driven model, but uptake of services has not been as high as expected. This qualitative study aimed to learn more about these key populations in Beira, their experiences of accessing MSM-and transgender-friendly services and their use of face-to-face and virtual networks, including social media, for engagement with health care. Methods In-depth interviews were carried out with MSM and transgender women who were 1) enrolled in, 2) disengaged from or 3) never engaged in MSF's programme. Purposive and snowball sampling were used to recruit the different groups of interviewees. Interviews were conducted in Portuguese, transcribed and translated into English before being coded and manually analysed using a thematic network framework. Results Nine transgender women and 18 cisgender MSM participated in the study. Interviewees ranged in age from 19 to 47 years, with a median age of 29. Three main themes emerged from the data: perceptions of stigma and discrimination, experiences of the peer-educator driven model and the use of face-to-face and virtual platforms for communication and engagement,
Global Public Health, 2016
We used qualitative, quantitative and observational methods to assess the feasibility, acceptability, and potential efficacy of Proyecto Orgullo (PO), a pilot community mobilisation intervention to decrease sexual risk, promote health-seeking behaviours, and facilitate personal and community empowerment among gay men (GM) and transgender women (TW) in Peru. PO was adapted from Mpowerment and Hermanos de Luna y Sol, two US interventions. PO included six interrelated core elements: 1) Self-reflection Small Group sessions; 2) Supporting peers in HIV prevention; 3) Mobilisation Activities addressing HIV, GM/TW issues, and community empowerment; 4) A Core Group (staff + GM/TW volunteers) designing/implementing those activities; 5) A Project Space; 6) Publicity. PO included specific components for TW, but promoted that GM/TW, who historically have not worked well together, collaborate for a common goal. We found that PO was embraced by GM/TW. PO positively influenced GM/TW's HIV prevention beliefs, self-efficacy, and behaviours; provided social support and created community; facilitated individual and community empowerment; achieved that GM/TW collaborate; and established a functional Community Centre for socializing/conducting mobilisation activities. Community mobilisation strategies, lacking from HIV prevention efforts in Peru but considered key to HIV prevention, can help improve health-seeking behaviours and consolidate social norms supporting preventive behaviours among GM/TW.
Adaptation of an effective school-based sexual health promotion program for youth in Colombia
Social Science & Medicine, 2019
Given the disproportionate impact of HIV and STIs among youth in Latin America, there is a compelling need for effective sex education programs. In particular, Colombia lacks a nationally standardized youth sex education program, despite the fact that 15 to 24-year-olds accounted for the highest incidence and prevalence rates of HIV and STIs in the nation. In an attempt to fill this void, our team adapted COMPAS, a Spanish school-based sexual health promotion intervention, for Colombian adolescents. Objective: This study describes the adaptation process that resulted in a modified version of COMPAS for youth in Colombia. Method: We employed a systematic cultural adaptation process utilizing a mixed methods approach, including intervention adaptation sessions with 100 young adolescents aged 15–19. The process included six steps: 1) consulting international researchers and community stakeholders; 2) capturing the lived experiences of a diverse sample of colombian youth; 3) identifying priorities and areas in need of improvement; 4) integrating the social cognitive theory, information-motivation-behavioral skills model, and an ecological framework for colombian youth; 5) adapting intervention content, activities, and materials; and 6) quantitative evaluation of COMPAS by Colombian youth. Results: The adapted intervention incorporates elements common to effective youth sex education interventions, including: a solid theoretical foundation, sexual communication skills and social support for protection, and guidance on how to utilize available cultural- and linguistic-appropriate services. In addition, the adapted intervention incorporates cultural and linguistic appropriate content, including an emphasis on tackling machismo to promote risk reduction behaviors. Conclusions: The systematic adaptation approach to sexual health intervention for youth can be employed by researchers and community stakeholders in low-resource settings for the promotion of health wellness, linkage to care, and STI and unplanned pregnancy prevention for youth.
Journal of Migration and Health, 2024
Background: The crisis in Venezuela has forced almost eight million people to flee to mainly neighbouring countries, including Brazil. Half of the displaced Venezuelans are women and girls, with adolescent girls facing distinctive challenges to their sexual and reproductive health during displacement and settlement. The aim of this study is to understand the barriers and facilitators for the sexual and reproductive health of adolescent Venezuelan girls residing in Brazil. Methods: The study used qualitative methods, including semi-structured interviews with 19 Venezuelan migrant adolescent girls conducted in Boa Vista and Manaus. We analysed transcripts using thematic analysis, and mapped findings to a theoretical framework based on the Bronfenbrenner Socio-ecological Model, which we adapted to explore how intersectional vulnerabilities at the individual level interact with contextual factors creating barriers and facilitators for health and rights of migrant adolescent girls. Results: Venezuelan adolescent migrants in Brazil face practical and structural barriers in realising their sexual and reproductive health and rights in four areas: menstruation; family planning, contraception and sexually transmitted infection; prenatal, childbirth and postnatal care; and preventing gender-based violence. The reported barriers were lack of knowledge around sexual and reproductive health rights, exposure to violence and lack of access to age-appropriate healthcare services. Mitigating factors included education (both in the family setting and at school); prevention activities undertaken by health services; care provision from non-governmental organisations and international agencies; and best practices in local health services. Conclusions: Host states must take action to enhance the right to sexual and reproductive health for adolescent migrants to allow them to make autonomous, independent and informed choices. A socioecological perspective on sexual and reproductive health and rights can help formulate intersectional policies that interconnect different levels of adolescent migrants' experience.
2014
This ethnographic study explores diverse ways in which sexuality and social hierarchies and inequalities interact in the lives of low-income youth who were trained as peer-educators and sexual health and rights advocates in Ayacucho, Peru. It examines three central questions: 1) How are meanings about sexuality related to social hierarchies and social prestige among these youth? 2) How do quotidian manifestations of social inequity shape vulnerability of youth to sexual abuse and sexual risks, and their sexual agency to face these situations? and 3) What are the possibilities and limitations of existent sexual rights educational programs to diminish sexual vulnerability of youth facing diverse forms of inequality, such as economic, gender, ethnic and inter-generational disparities? Table 1: Socio-Demographic Characteristics of Young Informants Characteristics Advocates and Peer Educators in Sexual and Reproductive Health and Rights (30) Attendants of Workshops about Sexual and Reproductive Health and Rights (10) Geographical provenance Rural migrant: 5 Rural migrant children: 22 Rural migrant grandchildren: 3 Rural migrant : 2 Rural migrant children: 6 Rural migrant grandchildren: 2 Gender Boys: 15 Girls: 15 Boys: 5 Girls: 5 Age 14 youth 15 to 16 years-old 16 youth 17 to19 years-old 4 youth 15 to16 years-old 6 youth 17 to19 years-old Number of children Boys: any boy had children Girls: 3 girls had children and one girl was pregnant Boys: any boy had children Girls: 1 girl had children
The project Culturally Appropriate Information, Education and Communication Strategies for Improving Adolescent Reproductive Health in Cusco, Peru was designed in response to the evident lack of information and education on adolescent reproductive health in the country and, in particular, in the rural areas of the department of Cusco. After analyzing the problems of adolescents in the Andean highlands, where childbearing rates, sexual activity, and induced abortions are on the rise and use of contraception is low, researchers found a demonstrated need for reproductive and sexual health education developed specifically for indigenous adolescents in this region. The Ministry of Education has implemented a Sexual Education Project at the national level, but lamentably, this program does not reach many rural schools. Very few teachers are trained to implement the national project and many do not have the materials necessary to use with their students. Comunicación Andina conducted an operations research study using a quasiexperimental separate sample pre-test and post-test design. Researchers conducted baseline and endline surveys of indigenous adolescents living in the Quispicanchis and Canchis provinces in the rural areas of the department of Cusco, Peru. The adolescents were third, fourth and fifth year students attending 13 high schools (ninth, tenth, and eleventh grade U.S. equivalent). Participant communities were selected that had a high school and were within the broadcast area of a local radio station. Most of the selected communities were district capitals. Researchers measured the knowledge and attitudes of adolescents living in the broadcast range of an educational radio series. The radio program was transmitted every weekday for 10 months by a network of five radio stations in the selected communities for a total of 185 programs. Information gathered through the needs assessment in the pre-test provided the framework for the production and development of the radio programs. Parallel to the radio programs, the research team identified and trained "peer promoters" in each of the schools. Researchers and resource people conducted training workshops for these adolescent leaders to deepen their understanding of many sexual and reproductive health topics and to get information from them about their most relevant problems. The trained adolescents served as promoters of the radio program in their schools and suggested many topics to be developed into radio programs. The key research instruments designed and implemented by the project team included two surveys to collect general descriptive data about the adolescent sample and information on knowledge, attitudes and practices of sexual and reproductive health. The self-administered, structured questionnaires asked about demographic characteristics, sex and sexuality, parts and functions of the male and female genitals, developmental changes during adolescence, attitudes and behavior related to sexuality, adolescent pregnancy and how to avoid it, consequences of pregnancy for girls, family planning
PLOS ONE, 2022
Background Adolescent sexual and reproductive health services in Chile have been primarily provided through health centers. Although some school-based initiatives have been implemented, to date, these have not been assessed. This study aims to identify strengths and challenges of the affectivity and sexuality component of the school-based 3A Program, a health program which seeks to prevent risk behaviors and promote healthy lifestyle habits within public schools (addressing health topics which in Spanish begin with the letter ‘A’, hence ‘3A’), implemented in the municipality of Lo Prado, city of Santiago. Methods We carried out a qualitative study with a descriptive-interpretative approach in three schools. We conducted in-depth interviews with students, teachers, health professionals, and school principals (N = 44); and focus groups with students (N = 3), teachers and health personnel (N = 3). The interviews were analyzed using thematic analysis. Results Participants highlight the integrative approach to health and to sexual and reproductive health promoted in the 3A Program, which is enhanced by the collaboration of interdisciplinary health teams. Permanent and expedited student access to sexual and reproductive health care is achieved, and affectional bonds are developed between students and the Program’s health staff. The Program assists female participants to imagine and form identities that are not inherently tied to motherhood. It also assists boys and LGBTQ+ adolescents in feeling included as relevant actors in sexual and reproductive health and decision making. The delivery of contraception in schools is highly valued. The most significant challenge identified is ensuring effective and ongoing collaboration between health staff and teachers. Conclusion Participants value the effectivity and sexuality component of the 3A Program as an initiative to improve adolescents’ access to sexual and reproductive health care. Our findings suggest that this Program could be replicated throughout the region and the country to improve the quality and accessibility of health services for adolescents.
2021
Introduction: The United States (U.S.) has higher rates of sexually transmitted infections (STIs) and adolescent pregnancy than most other industrialized countries. Furthermore, health disparities persist among racial and ethnic minority adolescents (e.g., African American and Latinx) and in counties located along the U.S.–Mexico border region – they demonstrate the highest rates of STIs and unintended pregnancy among adolescents.Methods: Qualitative data were collected as part of formative research for the development of a mobile app that provides gender-inclusive sexual education to adolescents living in the U.S. – Mexico border region. From August 2019 to March 2020, in-depth interviews and focus groups were conducted with healthcare providers (n=11) and cisgender, heterosexual, and SGM adolescents ages 15-18 (n=3; 20 participants).Results: Providers and adolescents reported similar barriers to accessing SRH in this region such as transportation, lack of insurance and cost of ser...