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IF 3.1 2区心理学 Q1 PSYCHOLOGY

Health Psychology Pub Date : 2025-03-01 DOI:10.1037/hea0001447

Ala Koreitem, A Rain Mocello, Jose Luis Gomez, Gustavo Saggese, Torsten Neilands, Maria Amelia de Sousa Mascena Veras, Sheri A Lippman, Jae Sevelius

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引用次数: 0

摘要

目标：交叉歧视会导致变性（跨性别）女性的不良健康后果。为了满足对测量交叉歧视经历的有效工具的需求，我们评估了交叉歧视指数（InDI）的性能，并测量了与巴西圣保罗变性女性的心理健康和医疗保健参与度之间的关联：利用 Manas por Manas 随机对照试验（n = 392）的基线数据，我们使用 InDI-预期歧视（InDI-A）、日常歧视（InDI-D）和重大歧视（InDI-M）分量表描述了参与者的交叉歧视经历。我们使用确认性因子分析评估了 InDI-A 的有效性，使用 Cronbach's coefficient alpha (Cα) 评估了其可靠性，并探讨了各分量表、心理健康和医疗参与之间的关系：结果：InDI-A 的单因素解结果极佳。所有分量表都显示出良好的可靠性：InDI-A（Cα = .85）、InDI-D（终生 Cα = .84，过去一年 Cα = .87）、InDI-M（终生 Cα = .78，过去一年 Cα = .76）。预期歧视每增加一个单位就会导致严重的心理困扰（调整后的几率比（AOR）=2.13，95% 置信区间（CI）[1.57, 2.89]，p < .0001）和自杀倾向（AOR = 1.44，95% CI [1.08, 1.93]，p < .05）。重大歧视和日常歧视也出现了类似的模式。我们观察到不同种族之间存在重要差异。预期的歧视与较高的 HIV 检测几率相关（AOR = 1.46，95% CI [1.08，1.97]，p = .013）。歧视与获得初级医疗服务无关：InDI是衡量巴西跨性别女性交叉歧视的有效、可靠的工具；InDI得分与负面心理健康后遗症密切相关。在巴西，变性女性的心理健康状况不佳，艾滋病感染率也很高，因此需要采取干预措施来减少获得医疗服务的结构性障碍。(PsycInfo Database Record (c) 2025 APA，保留所有权利）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Intersectional discrimination, mental health, and health care access among transgender women in Brazil.

Objectives: Intersectional discrimination leads to negative health outcomes among transgender (trans) women. To address the need for validated tools to measure experiences of intersectional discrimination, we evaluated the performance of the Intersectional Discrimination Index (InDI) and measured associations with mental health and health care engagement among trans women in São Paulo, Brazil.

Method: Using baseline data from the Manas por Manas randomized controlled trial (n = 392), we characterized participant experiences of intersectional discrimination using the InDI-anticipated (InDI-A), day-to-day (InDI-D), and major (InDI-M) discrimination subscales. We evaluated the validity of the InDI-A using confirmatory factor analysis, and reliability using Cronbach's coefficient alpha (Cα) and explored relationships between each subscale, mental health, and health care engagement.

Results: A single-factor solution yielded excellent for InDI-A. All subscales demonstrated good reliability: InDI-A (Cα = .85); InDI-D (lifetime Cα = .84, past-year Cα = .87), InDI-M (lifetime Cα = .78, past-year Cα = .76). A one-unit increase in anticipated discrimination was associated with severe psychological distress, adjusted odds ratio (AOR) = 2.13, 95% confidence interval (CI) [1.57, 2.89], p < .0001, and suicidality (AOR = 1.44, 95% CI [1.08, 1.93], p < .05). Similar patterns emerged for major and day-to-day discrimination. We observed important differences by race. Anticipated discrimination was associated with higher odds of HIV testing (AOR = 1.46, 95% CI [1.08, 1.97], p = .013). Discrimination was not associated with accessing primary care.

Conclusion: The InDI is a valid and reliable tool for measuring intersectional discrimination among Brazilian trans women; InDI scores are strongly associated with negative mental health sequelae. Interventions are needed to mitigate structural barriers to care in Brazil, where poor mental health and HIV prevalence are high among trans women. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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来源期刊

Health Psychology 医学-心理学

CiteScore

4.90

自引率

2.40%

发文量

170

审稿时长

4-8 weeks

期刊介绍： Health Psychology publishes articles on psychological, biobehavioral, social, and environmental factors in physical health and medical illness, and other issues in health psychology.