title: Documentation Status as a Contextual Determinant of HIV Risk Among Young Transgender Latinas.
abstract: OBJECTIVE
  The purpose of this study was to explore the contextual factors that determine or mitigate vulnerability to HIV among Latina transgender women. Documentation status (legal authorization to live in the United States) has been cited by other studies as a barrier to recruitment or engagement in HIV-related care among immigrant Latinos, but not explored as a determinant of HIV risk for transgender immigrant Latinas.
  
  
  METHODS
  We collaborated with a community-based organization to explore these contextual, including social and structural, factors. In-depth interviews in Spanish captured life histories of eight 18- to 29-year-old transgender Latinas, who collectively self-identify as chicas trans. Codes were assigned deductively from the interview guide, and emerging themes were identified throughout data collection.
  
  
  RESULTS
  Most participants migrated to the United States from Central America after experiencing discrimination and violence in their countries of origin. Participants emphasized documentation status as a critical factor in three areas related to social and structural determinants of HIV risk: gender identity expression, access to services, and relationship power dynamics. Chicas trans who gained legal asylum reported greater control over sexual relationships, improved access to services, and less risky employment.
  
  
  CONCLUSIONS
  Documentation status emerged as a key HIV risk factor for this population. For undocumented transgender Latinas, legal asylum appears to be a promising HIV-related protective factor. Further research could assess whether legal assistance combined with wraparound support services affects HIV prevention for this population.
authors.affiliation: 1 School of International Service, American University , Washington, District of Columbia.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Palazzolo
authors.affiliation: 1 School of International Service, American University , Washington, District of Columbia.
authors.forename: Thespina J
authors.initials: TJ
authors.lastname: Yamanis
authors.affiliation: 1 School of International Service, American University , Washington, District of Columbia.
authors.forename: Maria
authors.initials: M
authors.lastname: De Jesus
authors.affiliation: 1 School of International Service, American University , Washington, District of Columbia.
authors.forename: Molly
authors.initials: M
authors.lastname: Maguire-Marshall
authors.affiliation: 2 Community Health Action Department , La Clínica del Pueblo, Washington, District of Columbia.
authors.forename: Suyanna L
authors.initials: SL
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D000328:Adult; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D005783:Gender Identity; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D006630:Hispanic or Latino / Q000331:legislation & jurisprudence / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D012306:Risk; D012725:Sexual Behavior; D063106:Transgender Persons / Q000523:psychology / Q000706:statistics & numerical data; D000069756:Undocumented Immigrants / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult; D008297:Male
keywords: HIV; access to care; public policy and advocacy; transgender