Lifetime homelessness among young transgender women in Lima, Peru is associated with HIV vulnerability: Results from a cross-sectional survey
Bibliographic record
Abstract
Transgender youth face disproportionately high rates of homelessness, which can increase vulnerability to HIV. In Peru, the incidence of HIV among transgender women has increased 19% since 2010 and young transgender women are a priority population for HIV prevention. We sought to estimate the proportion of young transgender women experiencing homelessness and associations between homelessness and HIV vulnerabilities. We recruited transgender women ages 16-24 years (N = 209) to participate in a biobehavioural survey and HIV and STI testing (chlamydia, syphilis, gonorrhea). Poisson regression models with robust standard errors were fit to estimate the association between past homelessness and past 6-month condomless sex, adjusted for potential confounding by age, education, sex work, non-injection drug use, post-traumatic stress disorder (PTSD), and violence. Among participants (median age 23 years), 68 (32.5%) had ever been homeless and 19 (9.1%) reported homelessness in the past 3 months. Overall, 51.5% of those who had been homeless reported past 6-month condomless sex compared to 29.1% of those who had never been homeless (p < 0.001). HIV prevalence was 44.6% among those with a history of homelessness and 39.6% among those who had never been homeless (p = 0.65); lifetime homelessness was significantly associated with increased sex work (p < 0.001), violence (p < 0.01), and PTSD (p < 0.001). In the model adjusting for age, education, and behavioural risk (sex work, non-injection drug use), participants who had been homeless had 1.43 times higher prevalence of past 6-month condomless sex (95% CI = 1.05-1.96); results were attenuated when adjusting for violence and PTSD. The high prevalence of homelessness among young transgender women sampled underscores the compounding HIV vulnerabilities faced by this population. Efforts to prevent homelessness and improve access to housing are urgently needed alongside healthcare services, including HIV prevention and treatment, to address the disproportionate HIV epidemic among young Peruvian transgender women.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".