Tonia Poteat

Tonia Poteat
University of North Carolina at Chapel Hill | UNC · Department of Social Medicine

PhD, MPH, PA-C

About

163
Publications
31,547
Reads
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6,789
Citations
Additional affiliations
April 2021 - present
University of North Carolina at Chapel Hill
Position
  • Professor (Associate)
September 2018 - March 2021
University of North Carolina at Chapel Hill
Position
  • Professor (Assistant)
July 2014 - August 2018
Johns Hopkins University
Position
  • Professor (Assistant)

Publications

Publications (163)
Article
Full-text available
Background Access to clinicians competent in transgender health remains a significant barrier and contributor toward health inequity for transgender people. Studies on access and barriers to care have predominantly evaluated transgender patients’ perceptions, but scant research has included the perspectives of clinicians. Aims We conducted a quali...
Article
Full-text available
Background: Racist socio-political and economic systems in the United States are root causes of HIV disparities among minoritized individuals. However, within HIV implementation science literature, there is scarce empirical research on how to effectively counter racism. This article names racism and White supremacy as key challenges to the success...
Article
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Background Black transgender women endure pervasive polyvictimization (experiencing multiple forms of violence throughout the lifespan). Polyvictimization is associated with poor mental health. Black transgender women also face barriers in access to healthcare, but the extent that such barriers modify the association between polyvictimization and p...
Article
Full-text available
Intimate partner violence (IPV) has been implicated in HIV acquisition and worse HIV outcomes. Limited research focuses on the experiences of Black gay and bisexual men. Using data from cross-sectional surveys in Baltimore, Maryland, and Jackson, Mississippi, we analyzed the association between IPV victimization and HIV-related outcomes among 629 a...
Article
Full-text available
Purpose Adherence to pre-exposure prophylaxis (PrEP) during periods of PrEP-indication (i.e., prevention-effective adherence) is critical for preventing HIV. We sought to describe factors associated with prevention-effective adherence trajectories among transgender women (TW) to inform PrEP implementation strategies. Methods Using data from The LI...
Article
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Critical hope centres optimism and possibilities for change in the midst of struggles for social justice. It was a central tenet of early participatory pedagogy and HIV research. However, critical hope has been overlooked in contemporary HIV research that largely focuses on risk and biomedical interventions in ways that obscure collective agency an...
Conference Paper
The provider-patient relationship is important in breast cancer care, and the patient's ability to relate to healthcare providers (HCPs) across intersectional identities is also important. Self-determination theory outlines autonomy (a sense of independence), competence (experiencing mastery), and relatedness (feeling connected to others) as key fa...
Article
Utilizing the Andersen Healthcare Utilization Model, we examined the role of neighborhood context on pre-exposure prophylaxis (PrEP) utilization among a sample of Black men who have sex with men (MSM) residing in a medium-sized city in the Deep South. Data were derived from a sample of 142 Black MSM aged 18–64 years who were eligible for PrEP from...
Article
Full-text available
Purpose of Review Transgender individuals are at disproportionate risk for HIV infection, with prevalence rates highest among transgender women of color. Antiretroviral therapy (ART)-treated people with HIV (PWH) are at increased risk for cardiovascular disease (CVD), in relation to persistent systemic immune activation and metabolic dysregulation....
Article
Background Guided by intersectionality frameworks, researchers have documented health disparities at the intersection of multiple axes of social status and position, particularly race and ethnicity, gender, and sexual orientation. To advance from identifying to intervening in such intersectional health disparities, studies that examine the underlyi...
Article
Purpose The incidence of new HIV infections is disproportionately high among Black men who have sex with men (BMSM) in Mississippi. Community-based organizations received funding through the ACCELERATE! initiative to implement interventions aimed at increasing BMSM’s access to HIV prevention, treatment and care interventions. Approach We conducted...
Article
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Cisgender men who have sex with transgender women face elevated risk for HIV, yet are understudied in prevention research. We conducted in-depth interviews with 19 men who have sex with transgender women in Baltimore, Maryland and Atlanta, Georgia to explore perspectives on HIV prevention. Participants used several strategies to reduce HIV risk: co...
Article
Introduction Existing data on cardiovascular disease among transgender people are inconsistent and are derived from nonrepresentative samples or population-based data sets that do not include transgender-specific risk factors such as gender-affirming hormone use and gender minority stressors. A nationally representative sample of cisgender and tran...
Article
Full-text available
Background Transgender women in the United States (U.S.) experience a disproportionate burden of HIV infection and challenges to engagement in HIV prevention and care. This excess burden is driven by structural and economic inequities. Microeconomic interventions may be effective strategies for reducing HIV inequities for this population. However,...
Article
Full-text available
There is growing evidence that people who are transgender and gender diverse (TGD) are impacted by disparities across a variety of cardiovascular risk factors compared with their peers who are cisgender. Prior literature has characterized disparities in cardiovascular morbidity and mortality as a result of a higher prevalence of health risk behavio...
Article
Full-text available
Background: Despite known differences in breast cancer by both race and sexual orientation, data on the intersectional experiences of Black sexual minority women (BSMW) along the care continuum are scant. This study sought to understand delays in breast cancer care by examining the intersection of race and sexual orientation. Methods: This onlin...
Article
Within the United States South, the socio-religious norms that shape life for many residents may have public health implications. Drawing from 12 key informant interviews, this study explores the role of religious institutions in HIV care and prevention access among transgender people of color in Southern cities. Findings suggest that while religio...
Article
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Black transgender women are disproportionately affected by violence and poor care-delivery, contributing to poor mental health. Little is known regarding the effect of transgender and gender diverse (TGD) community connection (TCC) on health. This analysis (a) explores relationships between TCC, polyvictimization, and mental health and (b) analyzes...
Preprint
BACKGROUND Guided by intersectionality frameworks, researchers have documented health disparities at the intersection of multiple axes of social status and position, particularly race and ethnicity, gender, and sexual orientation. To advance from identifying to intervening in such intersectional health disparities, studies that examine the underlyi...
Article
Full-text available
The genesis of the concept of intersectionality was a call to dismantle interlocking systems of oppression – racial, sexual, heterosexual, and class-based – in order to realise liberation of Black women and other women of colour. Intersectionality holds the radical potential to amplify collective efficacy, community solidarity, and liberation. The...
Article
Introduction: Preexposure prophylaxis (PrEP) is effective in preventing HIV among adherent users. However, PrEP uptake among transgender women is low, and current prescribing guidelines from the Centers for Disease Control and Prevention (CDC) are not specific to transgender women. Self-perceived risk of HIV among those who are PrEP-indicated is n...
Article
Background Hispanic/Latino sexual and gender minorities (SGM) are the fastest growing ethnic group of SGM in the United States. Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among Hispanics/Latinos. SGM inequities in CVD risk have been identified as early as young adulthood, and minority stress has been identified as a...
Article
Background: Despite disproportionate incidence and prevalence of HIV among transgender individuals, cisgender women, and racial and ethnic minority groups, all remain under-represented in HIV cure research. As HIV cure trials are scaled up, there is emerging research on ways to mitigate risks of HIV acquisition for sexual partners of analytical tre...
Article
Background Probability and nonprobability-based studies of U.S. transgender persons identify different disparities in health and health care access. Objectives We used TransPop, the first U.S. national probability survey of transgender persons, to describe and compare measures of health and health access among transgender, nonbinary and cisgender...
Article
Full-text available
Background The HIV epidemic disproportionately impacts transgender women in the United States. Cohort studies identify unique risks for affected populations, but use of facility-based methods may bias findings towards individuals living in research catchment areas, more engaged in health services, or, in the case of transgender populations, those w...
Preprint
BACKGROUND The HIV epidemic disproportionately impacts transgender women in the United States. Cohort studies identify unique risks for affected populations, but use of facility-based methods may bias findings towards individuals living in research catchment areas, more engaged in health services, and/or, in the case of transgender populations, tho...
Article
Full-text available
Objectives: Innovative methods are needed for identification of transgender people in administrative records for health research purposes. This study investigated the feasibility of using transgender-specific healthcare utilisation in a Canadian population-based health records database to develop a computable phenotype (CP) and identify the propor...
Article
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Objective: Examine recent trends and differences in all-cause and cause-specific hospitalization rates by race, ethnicity, and gender among persons with HIV (PWH) in the US and Canada. Design: HIV clinical cohort consortium. Methods: We followed PWH ≥18 years old in care 2005-2015 in six clinical cohorts. We used modified Clinical Classificati...
Article
Objective Healthcare system distrust (HCSD) has been linked to poor breast cancer outcomes. Previous HSCD analyses have focused on Black‐White disparities; however, focusing only on race ignores the complex set of factors that form identity. We quantified the contributions of race and sexual minority (SM) identity to HCSD among US women who had rec...
Article
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Objectives Understanding barriers to care for transgender people with cancer is necessary to increase oncologic care access. Little has been published regarding the experiences of transgender people with cancer. We sought to explore these experiences, assess barriers to oncologic care, and elucidate potential solutions. Methods Using an interpreti...
Article
New diagnoses of HIV infection have decreased among women in the USA overall, but marked racial and geographical disparities persist. The federal government has announced an initiative that aims to decrease the number of new infections in the nation by 90% within the next 10 years. With this in mind, we highlight important recent developments conce...
Article
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In the United States, transgender women are disproportionately burdened by HIV infection. Research aimed at curbing the HIV epidemic for this population may benefit from innovative technology to engage participants in research. Adult transgender women (n = 41) from six cities in the southern and eastern United States participated in seven online fo...
Chapter
Transgender communities of color face inequities in HIV prevalence, uptake of prevention interventions, and engagement in care and treatment. Intersecting oppression, i.e., racism, cissexism, transphobia, and HIV stigma, increases HIV vulnerability and reduces access to prevention and care services. Healthcare providers can facilitate care engageme...
Article
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Self-administration of quality gender-affirming hormones is one approach to expanding access to hormone therapy for individuals seeking secondary sex characteristics more aligned with their gender identity or expression and can be empowering when provided within safe, supportive health systems. To inform World Health Organization guidelines on self...
Article
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Forty-four percent of Black transgender women are living with HIV, and many face challenges with HIV care engagement. An HIV cure has much to offer this population, however little HIV cure-related research has included them. We conducted 19 face-to-face in-depth interviews with 10 Black transgender women living with HIV. Interviews were audio recor...
Conference Paper
As lesbian, gay, bisexual, transgender, and queer (LGBTQ) people gain increasing acceptance in U.S. society, physicians are at an important turning point. Older physicians who entered medicine when homophobia was still the norm are interacting with new generations of physicians who have emerged through the cultural debates, and increased acceptance...
Article
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Chronic disease is a growing concern for research, policy and clinical care. While the global burden of HIV for transgender populations has been comprehensively covered in recent systematic reviews, the same is not true for the burden of other chronic disease. The objective of this study was to review the literature on non-HIV chronic disease burde...
Article
There is mounting evidence that lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) adults experience disparities across several cardiovascular risk factors compared with their cisgender heterosexual peers. These disparities are posited to be driven primarily by exposure to psychosocial stressors across the life span. This America...
Article
Full-text available
Background: Few studies have explored how the intersection of race and sexual identity contribute to breast cancer disparities for Black sexual minority women (SMW). Issues within patient-provider relationships, including bias, contribute to health disparities for minority groups. The authors used constructs from self-determination theory (SDT) to...
Article
Background: COVID-19 is a new pandemic, and its impact by HIV status is unknown. National reporting does not include gender identity, therefore data are absent on the impact of COVID-19 on transgender people, including those with HIV. Baseline data from the American Cohort to Study HIV Acquisition Among Transgender Women in High Risk Areas (LITE)...
Article
Background: A growing body of research is beginning to elucidate reasons people living with HIV (PLWHIV) might prefer oral daily antiretroviral treatment (ART) compared to emerging long-acting ART (LA-ART) or HIV remission strategies under investigation. Our objective is to provide qualitative insights into the reasons why PLWHIV might prefer one...
Article
Purpose: This study examines the relationship between polyvictimization, emotional transgender and gender diverse community connection (eTCC), and symptoms of depression and post-traumatic stress disorder (PTSD) among Black and Latinx transgender women in Baltimore, MD, and Washington, DC. Methods: A purposive sample (N = 197) completed surveys co...
Preprint
Full-text available
Background: COVID-19 is a new global pandemic and people with HIV may be particularly vulnerable. Gender identity is not reported, therefore data are absent on the impact of COVID-19 on transgender people, including transgender people with HIV. Baseline data from the American Cohort to Study HIV Acquisition Among Transgender Women in High Risk Area...
Article
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Background Transgender women (TW) are disproportionately affected by both HIV and cardiovascular disease (CVD). Objectives We aim to quantify prevalence of elevated predicted CVD risk for TW compared to cisgender women (CW) and cisgender men (CM) in HIV care and describe the impact of multiple operationalizations of CVD risk score calculations for...
Article
Background: Transgender stigma is rampant within healthcare systems in the United States. Transgender adults assigned female at birth – including those identifying as transmasculine or non-binary – face unique barriers, such as stigma when accessing sexual and reproductive healthcare labeled as being for “women.” However, transgender and non-binary...
Article
Background The South African national HIV plan recommends pre-exposure prophylaxis (PrEP) for transgender women, whose HIV prevalence estimates are as high as 25% in sub-Saharan Africa. The aim of this study was to explore PrEP awareness, uptake, and willingness, as well as associated barriers and facilitators, in order to inform PrEP implementatio...
Article
Full-text available
Background: Transgender women ("trans women"), particularly African-American and Latina trans women, have disproportionately high prevalence of HIV in the United States (U.S.). In order to decrease gender dysphoria and overcome discrimination, trans women affirm their gender through social and medical transition, often in contexts of economic hard...
Article
HIV prevalence is elevated among transgender populations with an estimated 13.7% of transgender adults living with HIV in the USA. In addition, transgender people experience significant disparities in biomedical HIV prevention and treatment. The efficacy of topical microbicides for prevention of HIV acquisition have not been tested among transgende...
Article
Objectives Though highly vulnerable to HIV and STIs, transgender female sex workers (TFSWs) are understudied in the US HIV and STI response. This study examined the correlates of laboratory-confirmed STIs among a cohort of 62 TFSWs followed over the course of 1 year and explored associations between specimen site and self-reported engagement in ins...
Article
Full-text available
Black communities in the United States are bearing the brunt of the COVID-19 pandemic and the underlying conditions that exacerbate its negative consequences. Syndemic theory provides a useful framework for understanding how such interacting epidemics to develop under conditions of health and social disparity. Multiple historical and present-day fa...
Article
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Background: HIV testing and pre-exposure prophylaxis (PrEP) are effective HIV prevention strategies often underutilized by transgender people. Methods: Recruitment occurred in two phases to identify transgender respondents in a probability sample of adults in the United States. Transgender respondents completed a self-administered paper or web-b...
Article
Full-text available
Background Black and Latina transgender women (TW) experience a disparate burden of HIV and related comorbidities, including poor mental health and cardiovascular disease (CVD) risks. Pervasive multilevel stigma and discrimination operate as psychosocial stressors for TW living with HIV and shape health disparities for this population. Gender-affir...
Article
Full-text available
Introduction In the USA, transgender women are among the most vulnerable to HIV. In particular, transgender women of colour face high rates of infection and low uptake of important HIV prevention tools, including pre-exposure prophylaxis (PrEP). This paper describes the design, sampling methods, data collection and analyses of the TURNNT (‘Trying t...
Preprint
Full-text available
Objectives: Though highly vulnerable to HIV and STIs, transgender female sex workers (TFSW) are understudied in the U.S. HIV and STI response. This study examined the correlates of laboratory-confirmed STIs among a cohort of 62 TFSW followed over the course of one year and explored associations between specimen site and self-reported engagement in...
Article
In the HIV pandemic, cisgender (ie, non-transgender) men with transgender partners are an underserved population. Complexities of sexuality and gender affect HIV vulnerability for this group, including not identifying with conventional sexual orientation categories (eg, bisexual, heterosexual, or gay) and having attractions based on gender role or...