Amaya Gabriela Perez-Brumer

Amaya Gabriela Perez-Brumer
University of Toronto | U of T · Division of Social and Behavioural Health Sciences

MSc

About

90
Publications
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2,182
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Publications

Publications (90)
Conference Paper
Full-text available
Venezuelan migration is the second largest international displacement in contemporary history. Yet, amid global calls for the inclusion of migrants and refugees in COVID-19 vaccination priority groups, little is known about how Latin American countries are prioritising COVID-19 vaccination for Venezuelans. This rapid scoping addresses this gap, tak...
Article
The Seasonal Agricultural Worker Program (SAWP) is a managed migration programme that aims to fill labour shortages in Canada's agricultural industry with Black and Brown workers from the global South. For decades, migrant workers, scholars, and advocate groups have called for fundamental changes to address power imbalances produced by the design o...
Article
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Sexual and gender politics inform relational expectations surrounding sexual experiences of Peruvian transgender women (TW) and men who have sex with men (MSM). We used the framework of sexual role strain, or incongruence between preferred sexual role and actual sexual practices, to explore potential conflicts between personally articulated identit...
Article
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To inform culturally relevant HIV prevention interventions, we explore the complexity of sex work among Peruvian transgender women. In 2015, we conducted twenty in-depth interviews and demographic surveys with transgender women in Lima, Peru to examine how transgender women enact individual- and community-level resistance strategies within a contex...
Article
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Purpose of review: This paper provides a critical review of recent therapeutic advances in long-acting (LA) modalities for human immunodeficiency virus (HIV) treatment and prevention. Recent findings: LA injectable antiretroviral therapy (ART) has been approved in the United States, Canada and Europe; the United States also has approved LA injec...
Article
In February 2021, the Peruvian ‘vaccinegate’ scandal broke when the media reported that nearly 500 experimental doses of an ongoing COVID-19 trial were given to key individuals not enrolled in the trial. Indeed, vaccine doses were administered to leading politicians, such as the former President and his wife, and other high-level health officials a...
Article
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Introduction The entangled health and economic crises fueled by COVID-19 have exacerbated the challenges facing Venezuelan migrants. There are more than 5.6 million Venezuelan migrants globally and almost 80% reside throughout Latin America. Given the growing number of Venezuelan migrants and COVID-19 vulnerability, this rapid scoping review examin...
Article
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Introduction Although pre-exposure prophylaxis (PrEP) is a remarkable biomedical advance to prevent HIV, ongoing research on PrEP contributes to and interacts with a legacy of HIV experimentation on marginalized communities in resource-limited settings. This paper explores the complexity of PrEP research mistrust among Peruvian transgender (trans)...
Article
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Menstruation research has largely focused on addressing menstrual management barriers facing cisgender women and girls in low and middle-income countries. Scant literature has assessed the menstrual management needs of trans and non-binary people assigned female at birth. To better understand these frequently invisibilised menstruation-related need...
Article
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Background: The health of transgender men (trans men)-individuals who identify as men and were assigned a female sex assigned at birth-is overlooked globally. This mixed-methods exploratory study sought to understand the lived experiences, health, and social needs of trans men in Lima, Peru to bring visibility to specific health needs and inform r...
Article
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Sexual communication with partners informs risk assessment and sexual practices. We evaluated participant, partner, and network factors associated with communication about condom use and HIV serostatus and explored their relationships with condomless anal intercourse (CAI) among 446 men who have sex with men (MSM) and 122 transgender women (TW) in...
Article
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Background Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social n...
Article
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We conducted a pilot randomized controlled trial of a social network-based intervention to promote PrEP adherence among transgender women (TW) in Lima, Peru. We enrolled 89 TW from six social networks and cluster-randomized them 1:1 to standard of care (n = 44) or the TransPrEP intervention (n = 45). Core workshops discussed strategies to support P...
Article
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This special issue of Global Public Health brings together papers examining how sexuality, gender, health and human rights have become increasing visible and highly contested within global health. The papers included here question and explore the often contradictory processes through which global equity-seeking populations negotiate pleasure and da...
Article
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Social marginalization harms lesbian, gay, bisexual, and transgender (LGBT) persons’ wellbeing in Lesotho. Socio-cultural mechanisms linking LGBT stigma, depression, substance use, and HIV among LGBT persons in Lesotho are understudied. We explore associations between LGBT stigma, mental health stressors, and HIV vulnerabilities among LGBT persons...
Article
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To improve understanding of factors associated with intimate partner violence (IPV) and explore its role in sexually transmitted infection (STI) acquisition, we analyzed partnership-level correlates of IPV among men who have sex with men (MSM) and transgender women (TW) in Peru. In a 2017 cross-sectional study of rectal STI screening and HIV preven...
Article
As part of a planned series from Global Public Health aimed at exploring both the epistemological and political differences in diverse public health approaches across different geographic and cultural regions, this special issue assembles papers that consider the legacy of the Latin American Social Medicine and Collective Health (LASM-CH) movements...
Conference Paper
Background Although syphilis remains a central public health problem, disease estimates for men who have sex with men (MSM) and transwomen (TW) in the Americas are incomplete. The purpose of this study was to compare the syphilis epidemics of North America (NA) and Latin America/Caribbean (LAC). Methods We conducted a systematic review of ten data...
Article
Cisgender men (CM) who report transgender women (TW) as sexual partners are an understudied population in the HIV epidemic in Latin America. The current study sought to characterize this group in a 2012 cross-sectional online survey of Latin American CM who were members of a sexual networking website for men who have sex with men (N = 11,847). Mult...
Article
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HIV disproportionately impacts transgender communities and the majority of new infections occur in the Southern United States. Yet, limited data exists on contextual realities of HIV vulnerability and healthcare needs among transgender individuals in the Deep South. Addressing this gap in the literature, we assess the health needs, including barrie...
Data
In-depth qualitative interview guide included as supporting information. (DOCX)
Article
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The magnitude of gender identity-related disparities in school-based outcomes is unknown because of a lack of representative studies that include measures of gender identity. By utilizing a representative sample generalizable to a broader population, this study elucidates the size of gender identity-related disparities, independent of sexual orient...
Poster
BACKGROUND: While men who have sex with men (MSM) and transgender women (TW) have been the focus of numerous combined HIV prevention strategies, these groups still account for more than 60% of new HIV infections in Peru. To improve understanding of factors influencing PrEP knowledge and uptake, we studied PrEP awareness and motivations/barriers to...
Article
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Background: Patient-initiated partner notification (PN) following the diagnosis of a sexually transmitted infection is a critical component of disease control in men who have sex with men (MSM) sexual networks. Both printed and internet-based technologies offer potential tools to enhance traditional partner notification approaches among MSM in res...
Article
Swaziland has among the highest national adult HIV prevalence globally. There is limited knowledge of HIV vulnerabilities and prevention engagement among lesbian, gay, bisexual and transgender (LGBT) persons in the context of Swaziland’s criminalization of consensual same-sex practices. This study explored social processes of marginalization to ass...
Article
Background: Gonorrhea (GC) and chlamydia (CT) disproportionately affect men who have sex with men (MSM), and public health implications vary by anatomic site and bacterial agent. Urethral and rectal GC and CT can increase risk of HIV transmission, while pharyngeal GC may be a reservoir for antimicrobial resistance. To define screening priorities in...
Article
Social, cultural, and institutional processes which see heterosexuality as natural and universal discriminate against individuals who differ from this norm. This article draws on interviews with lesbian, gay, bisexual, and transgender (LGBT) people in Swaziland to provide an enhanced understanding of the ways in which heterosexism operates in pract...
Article
Purpose: The purpose of this study was to examine rates of substance use between transgender and nontransgender youth using a representative population-based sample and to examine mediating risk factors. Methods: A statewide cross-sectional sample of California middle and high schools collected between 2013 and 2015. This representative sample o...
Article
Objective No representative population-based studies of youth in the US exist on gender identity-related disparities in suicidal ideation or on factors that underlie this disparity. To address this, we: (1) examined gender identity-related disparities in the prevalence of suicidal ideation; (2) evaluated whether established psychosocial factors exp...
Conference Paper
Introduction Endemic rates of STIs like GC/CT and syphilis in Peru are only partially explained by individual behavioural or biological factors. Characterisation of sexual networks of MSM/TW with syphilis and/or GC/CT can provide critical data to inform prevention efforts. Methods We enrolled 917 MSM/TW as screening for 2 STI control trials in Lim...
Conference Paper
Introduction Swaziland has the highest national adult HIV prevalence globally at 28.8%. Given the criminalization of same-sex practices, there is limited data on the experiences of lesbian, gay, bisexual and transgender (LGBT) persons’ engagement with HIV prevention and treatment services. Research is urgently needed to understand barriers and faci...
Conference Paper
Introduction Community acceptability and sustainability of new HIV prevention methods remain key barriers to curb high HIV incidence rates for transgender women (TW) in Peru. Improved understanding of how geography, culture, and socialisation influence HIV-associated risks and uptake of new prevention technologies is critical to address the HIV epi...
Conference Paper
Introduction Partner notification (PN) is a key component of STI prevention efforts, yet, is underutilised by MSM, a population at-risk for STIs and HIV in Peru. To understand limiting mechanisms, we examined the dimensionality and latent factor structure of perceived STI and HIV stigma and attitudes towards PN among MSM in Lima, Peru. Methods Bet...
Conference Paper
Introduction Traditional risk-reduction counselling has had limited effect in modifying patterns of high-risk sexual behaviour among MSM. New methods like Personalised Cognitive Counselling (PCC) can be used to understand and address contexts of HIV transmission risk. Methods We conducted interviews and focus groups with HIV-uninfected MSM in 3 st...
Article
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Zambia has a generalized HIV epidemic, and HIV is concentrated along transit routes. Female sex workers (FSWs) are disproportionately affected by the epidemic. HIV testing is the crucial first step for engagement in HIV care and HIV prevention activities. However, to date little work has been done with FSWs in Zambia, and little is known about barr...
Article
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Background: Expedited Partner Therapy (EPT) has been shown to improve treatment outcomes among heterosexual partners of individuals with curable sexually transmitted infections (STIs). Although the use of EPT with men who have sex with men (MSM) has been debated, due to the potential for missed opportunities to diagnose unidentified cases of HIV an...
Article
Background: A growing body of research has examined transgender identity development, but no studies have investigated developmental pathways as a transactional process between youth and caregivers, incorporating perspectives from multiple family members. The aim of this study was to conceptualize pathways of transgender identity development using...
Article
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Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among young men who have sex with men (YMSM) in the Deep...
Article
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Risk perception and health behaviors result from individual-level factors influenced by specific partnership contexts. We explored individual- and partner-level factors associated with partner-specific perceptions of HIV/STI risk among 372 HIV/STI-positive MSM and transgender women (TW) in Lima, Peru. Generalized estimating equations explored parti...
Article
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Sampling strategies such as respondent-driven sampling (RDS) and time-location sampling (TLS) offer unique opportunities to access key populations such as men who have sex with men (MSM) and transgender women. Limited work has assessed implementation challenges of these methods. Overcoming implementation challenges can improve research quality and...
Article
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Background: New strategies to support partner notification (PN) are critical for STD control and require detailed understanding of how specific individual and partnership characteristics guide notification decisions. Methods: From 2011 to 2012, 397 MSM and TW recently diagnosed with HIV, syphilis, or another STD completed a survey on anticipated...
Article
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Introduction: Critical technological advances have yielded a toolkit of HIV prevention strategies. This literature review sought to provide contextual and historical reflection needed to bridge the conceptual gap between clinical efficacy and community effectiveness (i.e. knowledge and usage) of existing HIV prevention options, especially in resour...
Article
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Introduction Despite the efficacy of pre-exposure prophylaxis (PrEP) in preventing HIV transmission, few studies have evaluated PrEP use and retention in care outcomes in real-world settings outside of clinical trials. Methods Data were collected from PrEP clinical care programmes in three mid-size US cities: Providence, Rhode Island (RI); Jackson...
Article
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The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV transmission are not fully understood. We examined relationships between substance use, sexual partnership characteristics, and condom non-use in an African American sample of STI clinic attendees in Jackson, Mississippi. We assessed condom non-use at last i...
Article
This double Special Issue of Global Public Health presents a collection of articles that seek more adequately to represent sexual and gender diversities and to begin to rethink the relationship to HIV prevention and health promotion – in both the resource rich nations of the global North, as well as in the more resource constrained nations of the g...
Article
The HIV epidemic has had a widespread impact on global scientific and cultural discourses related to gender, sexuality, and identity. ‘Male sex workers’ have been identified as a ‘key population’ in the global HIV epidemic; however, there are methodological and conceptual challenges for defining inclusion and exclusion of transgender women within t...
Article
The objective of this study was to characterize HIV testing practices among men who have sex with men in Mexico and intention to use HIV self-testing. In 2012, members of one of the largest social/sexual networking websites for men who have sex with men in Latin America completed an anonymous online survey. This analysis was restricted to HIV-uninf...
Article
Laws and policies can affect the HIV risk of key populations through a number of direct and indirect pathways. We investigated the association between HIV prevalence among men who engage in transactional sex and language in the penal code protecting sexual minorities, including men who have sex with men (MSM), and sex workers. HIV prevalence among...
Article
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Men who have sex with men (MSM) and other same-gender-loving (SGL) men continue to be disproportionately affected by HIV and AIDS, particularly among the Black population. Innovative strategies are needed to support the health of this community; however, public health efforts primarily approach MSM as a monolithic population erasing the diverse ide...
Article
Objectives: Partner notification (PN) following sexually transmitted disease (STI) diagnosis is a key strategy for controlling HIV/STI transmission. Anonymous partnerships are an important barrier to PN and often associated with high-risk sexual behaviour. Limited research has examined the profile of men who have sex with men (MSM) and transgender...
Article
BACKGROUND Differences in sexual health-related outcomes by sexual behavior and identity remain underinvestigated among bisexual female adolescents. METHODS Data from girls (N=875) who participated in the Massachusetts Youth Risk Behavior Surveillance survey were analyzed. Weighted logistic regression models were fit to examine sexual and psychosoc...
Article
Attention to transgender health has dramatically increased in the U.S. Scientific knowledge gaps in empirical research, however, remain and act as barriers to achieving transgender-related health equity. We conducted a search using PubMed and PsycINFO to identify gaps in empirical, peer-reviewed publications related to adult transgender health in t...
Conference Paper
Full-text available
Background. Young Black men who have sex with men (YBMSM) account for approximately 10% of the total HIV infection in the United States but represent less than 1% of the total population. To-date, little is known about the situation-specific factors influencing their sexual behaviors. Methods. Over eight-weeks, 154 YBMSM in New York City completed...
Article
In Venezuela, members of a social and sexual partner-networking site for MSM completed an online survey regarding sexual behaviours and HIV medical care. Among the 2851 respondents, self-reported HIV prevalence was 6.6%. Of participants living with HIV, 73.2% reported taking antiretroviral medication and, 56.6% reported complete adherence within th...
Article
This cross-sectional study assessed sexually transmitted infection (STI) prevalence, socio-demographic characteristics, substance use, sexual behaviors, and sexual network profiles among African American sexual minorities in Jackson, Mississippi. Bivariate chi-square tests and generalized estimating equation (GEE) models explored individual and par...
Article
This study assessed individual (ie, internalized transphobia) and structural forms of stigma as risk factors for suicide attempts among transgender adults. Internalized transphobia was assessed through a 26-item scale including four dimensions: pride, passing, alienation, and shame. State-level structural stigma was operationalized as a composite i...
Article
Previous analyses of partner notification (PN) have addressed individual, interpersonal, social, and structural issues influencing PN outcomes but have paid less attention to the conceptual framework of PN itself. We conducted 18 individual interviews and 8 group discussions, in a two-stage qualitative research process, to explore the meanings and...
Article
OBJECTIVES: We assessed factors associated with engagement in transactional sex among men who have sex with men recruited from one of the largest Internet sites for men seeking social or sexual interactions with other men in Latin America. METHODS: We constructed multilevel logistic regression models to analyze factors associated with engagement in...
Article
Background: Stigmatizing social environments (of which 'structural stigma' is one component) negatively affect health-related outcomes. However, few studies have examined structural stigma related to sexual minority status as a risk factor for HIV outcomes among MSM. Methods: In August 2013, members of a large MSM social and sexual networking site...
Article
Engagement in transactional sex has been hypothesized to increase risk of HIV among MSM, however conflicting evidence exists. We conducted a systematic review and meta-analysis comparing HIV prevalence among MSM who engaged in transactional sex to those who did not (33 studies in 17 countries; n = 78,112 MSM). Overall, transactional sex was associa...
Article
Full-text available
The Mycobacterium tuberculosis complex causes tuberculosis in humans and nonhuman primates and is a global public health concern. Standard diagnostics rely upon host immune responses to detect infection in nonhuman primates and lack sensitivity and specificity across the spectrum of mycobacterial infection in these species. We have previously shown...
Conference Paper
OBJECTIVE:To assess whether stigmatizing social environments (i.e., structural stigma) were associated with suicide attempts among transgender adults. METHODS:State-level structural stigma was coded using a previously established measure (Hatzenbuehler, 2011) based on a 4-item composite index: (1) density of same-sex couples; (2) proportion of Ga...
Conference Paper
OBJECTIVE: To assess whether stigmatizing social environments (i.e., structural stigma) were associated with HIV risk behaviors among transgender adults. METHODS: State-level structural stigma was coded using a previously established measure (Hatzenbuehler, 2011) based on a 4-item composite index: (1) density of same-sex couples; (2) proportion o...
Conference Paper
OBJECTIVE: Black MSM are most heavily impacted by HIV in Mississippi (MS), though the factors driving this epidemic in the Deep South remain poorly understood. We examined the individual and partner-level risks among sexual minority men in Jackson, MS. METHODS: A cross-sectional study was conducted with men (n=492) receiving care at an urban STI...
Conference Paper
OBJECTIVE: Sexual minority women are often overlooked in HIV and STI-related studies however emerging evidence suggests this population may experience substantial vulnerabilities increasing their risk of transmission. Therefore we assessed individual and partner-level risk factors associated with HIV and STI transmission among sexual minority women...
Article
Background: 'Syndemic factors', defined as co-occurring psychological conditions including major depressive disorder, substance and alcohol use, and intimate partner violence, have been shown to increase HIV incidence among MSM in the United States. However, this relationship has not been well characterized in the general population, particularly i...
Article
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Young adults in South Africa are at the epicenter of the HIV epidemic. The prevalence of HIV among young people in the province of KwaZulu-Natal (KZN) is particularly high. This study characterizes inkwari (Zulu word for raves or weekend-long parties) in eThekwini District, KZN and explored how these place-based dynamics shape the risk environment...
Article
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Background Men who engage in transactional sex, the exchange of sex for money, goods, or other items of value, are thought to be at increased risk of HIV, but there have been no systematic attempts to characterize HIV burden in this population. We undertook a systematic review and meta-analysis to quantify the burden in this population compared wit...
Article
Full-text available
Few comparative data are available internationally to examine health differences by transgender identity. A barrier to monitoring the health and well-being of transgender people is the lack of inclusion of measures to assess natal sex/gender identity status in surveys. Data were from a cross-sectional anonymous online survey of members (n > 36,000)...