O2.5 - Mixed methods analysis of network structures, support exchanged, and communication patterns within the social networks of transgender women in Lima, Peru

Background

Social networks play a role in normative reinforcement of HIV prevention strategies, provision of support, knowledge sharing, and generating social capital, but little research has characterized the social networks of transgender women (TW) in Latin America. We conducted a mixed methods analysis of three network clusters of TW in Lima, Peru, to evaluate network composition, support exchanged, and communication patterns.



Methods

We recruited TW residing in or affiliated with three “casas trans” (houses shared among TW) in Lima between April-May 2018. Eligible participants were 18 or older, self-reported HIV-negative, and reported recent intercourse with a cis-male partner. Participants completed demographic questionnaires, social network interviews, and semi-structured interviews to assess egocentric network structures, support exchanged, and communication patterns. Quantitative and qualitative data were analyzed using Stata v14.1 and Atlas.ti, respectively.



Results

Of 20 TW, median age was 26 years and 100% reported involvement in transactional sex. Respondents identified 161 individuals they interacted with in the past month (alters), of whom 33% were TW and 52% family members. 70% of respondents reported receiving emotional support from family, while only 30% received financial support and instrumental support from family. Of the 13 (65%) respondents who nominated someone as a source of HIV prevention support, a majority (69%) nominated other TW. In a GEE Poisson model adjusted for participant education, income, region of birth, and alter gender identity, being a family member was associated with lower likelihood of providing financial support (PR 0.13, CI 0.03-0.51) and instrumental support (PR 0.18, CI 0.04-0.71). In qualitative interviews, almost all respondents identified a cis-female family member as the most trusted and closest individual within their network, but other TW were more often identified as sources of HIV prevention communication and support and other day-to-day support. Support exchanged between TW was more often bi-directional.



Conclusion

TW have complex and diverse social networks. Family members may represent important and influential components, yet there is a discrepancy between network members who are considered trusted and those who enforce HIV prevention norms. HIV prevention efforts could consider incorporating network-based interventions with TW community input as well as outreach efforts targeted to supportive family members.