The TRANScending Love Arts-Based Workshop to Address Self-Acceptance and Intersectional Stigma Among Transgender Women of Color in Toronto, Canada: Findings from a Qualitative Implementation Science Study.

Carmen H Logie,Ashley Lacombe-Duncan,Adrian Guta,Monica Forrester,Dahlak Mary Yehdego,Catherine Moses,Tatiana B Ferguson,Yasmeen Persad,Shannon Ryan

doi:10.1089/trgh.2018.0040

Abstract

Purpose: Transgender (trans) women of color's HIV vulnerabilities are shaped by social exclusion and intersectional stigma. There is a dearth of tailored HIV prevention interventions with trans women of color in Canada. The objective of the study was to explore trans women of color's HIV prevention priorities and to pilot test an intervention developed from these priorities.Methods: We conducted a qualitative implementation science study to develop HIV intervention strategies with trans women of color in Toronto, Canada. First, we conducted a focus group with trans women of color (n=8) to explore HIV prevention priorities. Second, we held a consultation with trans women of color community leaders (n=2). Findings informed the development of the TRANScending Love (T-Love) arts-based workshop that we pilot tested with three groups of trans women of color (n=18). Workshops were directly followed by focus groups to examine T-Love products and processes.Results: Focus group participants called for researchers to shift the focus away from trans women's bodies and HIV risks to address low self-acceptance produced by intersecting forms of stigma. The community leader consultation articulated the potential for strengths-focused arts-based approaches to address self-worth. T-Love participants described how workshops fostered self-acceptance and built connections between trans women of color.Conclusions: Findings demonstrate the feasibility and acceptability of an arts-based strategy with trans women of color to elicit group-based sharing of journeys to self-acceptance, fostering feelings of solidarity and connection. Providing opportunities for dialogue and reflection about individual and collective strengths may reduce internalized stigma among trans women of color.

Highlights

This community-based research (CBR) study was conducted in collaboration with an ACB AIDS service organization, a lesbian, gay, bisexual, transgender, and queer (LGBTQ) community center, a sex worker agency, and ACB trans women community leaders in Toronto, Ontario, Canada’s largest city.[37]
Participant characteristics A total of 28 trans women participated in the development (n = 10) and pilot testing (n = 18) of TRANScending Love (T-Love)
The preliminary focus group (n = 8) was followed by a consultation with ACB trans women community leaders (n = 2) who had extensive experience working in social service provision with trans women

Summary

Introduction

Trans women of color are disproportionately affected by HIV; meta-analytic findings from 29 studies in the United States reported a higher HIV seroprevalence among Black trans women (56.3%) than among White trans women (16.7%).[3] In Canada, HIV vulnerability has been reported among trans persons[12,13] and among African, Caribbean, and Black (ACB) Canadians at a population level.[14] In 2016, over one-fifth of new HIV diagnoses were among Black Canadians,[15] despite comprising less than 5% of the Canadian population.[14]. Despite the overrepresentation of ACB persons and trans women in HIV diagnosis, there is little known about the HIV prevention priorities of ACB trans women in Canada or other trans women of color who may experience shared HIV vulnerabilities.[11] A qualitative study with trans women living with HIV in Canada described a trajectory of marginalization, including socioeconomic exclusion, violence, and a lack of transspecific HIV prevention and support, which constrained trans women’s access to the HIV prevention cascade.[16]

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