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\"Unseen Flesh explores how Black lesbians in Brazil understand, navigate, and define their well-being and worth against racial, sexual, class, and gender-based prejudice. Nessette Falu analyzes the racist and heteronormative underpinnings of gynecology, and demonstrates how gynecology erases Black lesbian subjecthood through mental, emotional, and physical traumas. Drawing on ethnographic work with Black lesbian informants, Falu documents how Black lesbians resist erasure by asserting their worth and \"bem-estar Negra\" within and against gynecology's intimate violence\"-- Provided by publisher.

Since 2002, Brazil has been granting refugee status on the grounds of sexual orientation and gender identity (SOGI). This topic has become more visible in the last few years due to the large flow of Venezuelans crossing the border, many of whom are not heterosexual and/or cisgender. However, there is an older, although less visible, flow of African people, mainly from Nigeria, Ghana, and Cameroon, who travel to Brazil in order to claim asylum because of their SOGI. Despite the fact that more research has been conducted recently on the intersection between migration and sexuality, most of this scholarship focuses on South-North movements, not South-South migrations with destinations such as Brazil. The aim of this article is to analyse the central role played by political and social (in)visibility of SOGI forced migrants in Brazil and the (dis)advantages provided by their (in)visibility. In order to do so, I draw on twelve months of ethnographic fieldwork in the city of São Paulo, which included participant observation and semi-structured interviews with SOGI forced migrants from African countries. I also draw on secondary data from ethnographies carried out with SOGI forced migrants from Venezuela in the cities of Boa Vista and Rio de Janeiro, as well as on official data published by the Brazilian government. My argument is that SOGI forced migrants play with their own (in)visibility, making strategic decisions before migrating to Brazil, during their journeys, and after their arrival in the country.

The Roman Catholic church played a dominant role in colonial Brazil, so that women's lives in the colony were shaped and constrained by the Church's ideals for pure women, as well as by parallel concepts in the Iberian honor code for women. Records left by Jesuit missionaries, Roman Catholic church officials, and Portuguese Inquisitors make clear that women's daily lives and their opportunities for marriage, education, and religious practice were sharply circumscribed throughout the colonial period. Yet these same documents also provide evocative glimpses of the religious beliefs and practices that were especially cherished or independently developed by women for their own use, constituting a separate world for wives, mothers, concubines, nuns, and witches. Drawing on extensive original research in primary manuscript and printed sources from Brazilian libraries and archives, as well as secondary Brazilian historical works, Carole Myscofski proposes to write Brazilian women back into history, to understand how they lived their lives within the society created by the Portuguese imperial government and Luso-Catholic ecclesiastical institutions. Myscofski offers detailed explorations of the Catholic colonial views of the ideal woman, the patterns in women's education, the religious views on marriage and sexuality, the history of women's convents and retreat houses, and the development of magical practices among women in that era. One of the few wide-ranging histories of women in colonial Latin America, this book makes a crucial contribution to our knowledge of the early modern Atlantic World.

Background Transgender women are disproportionately affected by both HIV and gender-based violence (GBV), defined as physical, sexual, or emotional violence perpetrated against an individual based on their gender identity/expression. While a growing body of evidence demonstrates that GBV leads to poor HIV care and treatment outcomes among cisgender women, less research has examined this association among transgender women. We assessed the impact of lifetime experiences of GBV on subsequent retention in HIV care and laboratory confirmed viral suppression among a sample of transgender women living with HIV (TWH) in Brazil. Methods A pilot trial of a peer navigation intervention to improve HIV care and treatment among TWH was conducted in São Paulo, Brazil between 2018 and 2019. TWH were recruited and randomized into the intervention or control arm and participated in a baseline and 9-month follow-up survey and ongoing extraction of clinical visit, prescribing, and laboratory data. Generalized linear model regressions with a Poisson distribution estimated the relative risk (RR) for the association of lifetime physical and sexual violence reported at baseline with treatment outcomes (retention in HIV care and viral suppression) at follow-up, adjusting for baseline sociodemographic characteristics. Results A total of 113 TWH participated in the study. At baseline, median age was 30 years, and the prevalence of lifetime physical and sexual violence was 62% and 45%, respectively. At follow-up, 58% ( n  = 66/113) were retained in care and 35% ( n  = 40/113) had evidence of viral suppression. In adjusted models, lifetime physical violence was non-significantly associated with a 10% reduction in retention in care (aRR: 0.90, 95% CI: 0.67, 1.22) and a 31% reduction in viral suppression (aRR: 0.69; 95% CI: 0.43, 1.11). Lifetime sexual violence was non-significantly associated with a 28% reduction in retention in HIV care (aRR: 0.72, 95% CI: 0.52, 1.00) and significantly associated with a 56% reduction in viral suppression (aRR: 0.44; 95% CI: 0.24, 0.79). Conclusion Our findings are among the first to demonstrate that lifetime experiences with physical and sexual violence are associated with poor HIV outcomes over time among transgender women. Interventions seeking to improve HIV treatment outcomes should assess and address experiences of GBV among this population. Trial registration ClinicalTrials.gov Identifier: NCT03525340.

Known as Black Rome, Salvador da Bahia, Brazil, is a predominantly Black city. The local art, food, and dance are closely linked to the population’s African roots. Yet many Black Brazilian residents are politically and economically disenfranchised. Bryce Henson details a culture of resistance and activism that has emerged in response, expressed through hip-hop and the social relations surrounding it. Based on years of ethnographic research, Emergent Quilombos illuminates how Black hip-hop artists and their circles contest structures of anti-Black racism by creating safe havens and alternative social, cultural, and political systems that serve Black people. These artists valorize and empower marginalized Black peoples through song, aesthetics, media, visual art, and community action that emphasize diasporic connections, ancestrality, and Black identifications in opposition to the anti-Black Brazilian nation. In the process, Henson argues, the Salvador hip-hop scene has reinvigorated and reterritorialized a critical legacy of Black politicocultural resistance: the quilombo, maroon communities of Black fugitives who refused slavery as a way of life, gathered away from the spaces of their oppression, protected their communities, and nurtured Black life in all its possibilities.

Background Population heterogeneity and the lack of clinical and sociodemographic information in transgender individuals with gender dysphoria (GD) remains a challenge for specialized services in mental health and surgical procedures. It aimed to identify and describe profiles in a sample waiting for gender-affirming surgery. Methods A sample of 100 outpatients with GD was assessed through a structured interview, Emotion Regulation Difficulty Scale (DERS), Ruminative Response Scale (RRS), Depression, Anxiety and Stress Scale (DASS-21) and Life Satisfaction scale (SWLS). Cluster analysis was used to identify different profile categories. Results Two subgroups with different profiles were identified: with less clinical severity (LCS) and with high clinical severity (HCS) on emotional dysregulation, acute symptoms of depression, anxiety, stress and association with mental rumination. The HCS cluster had greater vulnerability in terms of psychiatric history, use of psychotropic drugs, HIV positive, child abuse and suicidal behavior. Conclusion Different profiles were found regarding the vulnerability to mental health in a sample of transgender people with GD who seek a public hospital service for the same clinical-surgical objective. Longitudinal studies are essential to monitor the impact of these contrasts and to target personalized therapeutic approaches in the prevention of psychiatric disorders.

HIV Pre-exposure prophylaxis (PrEP) is an effective prevention tool, but there are still few studies about PrEP uptake among adolescents. We aimed to analyze the PrEP uptake process and factors associated with daily oral PrEP initiation among adolescent men who have sex with men (aMSM) and transgender women (aTGW) in Brazil. Baseline data from the first demonstration PrEP cohort study among aMSM and aTGW 15–19 years old (yo) ongoing in three large Brazilian cities (PrEP1519). After completing informed consent procedures, participants were enrolled in the cohort from February/2019 to February/2021. A socio-behavioral questionnaire was applied. Factors associated with PrEP initiation were assessed using a logistic regression model with adjusted prevalence ratios (aPR) and 95% confidence intervals (95%CI). Among recruited participants, 174 (19,2%) were aged 15–17 yo and 734 (80,8%) 18–19 yo. The rate of PrEP initiation was 78.2% and 77.4% for 15–17 yo and 18–19 yo, respectively. Factors associated with PrEP initiation were: black or mixed race (aPR 2.31; 95%CI: 1.10–4.84) among the younger adolescents 15–17 yo; experienced violence and/or discrimination due to their sexual orientation or gender identity (aPR 1.21; 95%CI: 1.01–1.46); transactional sex (aPR 1.32; 95%CI: 1.04–1.68); and having had between 2 to 5 sexual partners in the previous three months (aPR 1.39; 95%CI: 1.15–1.68) among those 18–19 yo. Unprotected receptive anal intercourse in the previous six months was associated with PrEP initiation in both age groups (aPR 1.98; 95%CI: 1.02–3.85 and aPR 1.45; 95%CI: 1.19–1.76 among 15–17 yo and 18–19 yo, respectively). The biggest challenge to promoting PrEP use for aMSM and aTGW was in the first steps of the PrEP uptake process. Once they were linked to the PrEP clinic, initiation rates were high.

In recent years, Brazil and Poland have elected governments that are sceptical of both the liberal international order and gender. In both cases, contemporary administrations have bolstered the pre-existing anti-gender offensive of religious and secular conservative forces and converted this into legislation and public policy. Yet, at the same time, both have also created National Action Plans around the UN's Women, Peace and Security agenda. Why is this the case? Why do two governments that see gender as an ‘ideology’ continue to work on WPS? Using a feminist institutionalist framework, this article draws on content analysis of the NAPs and semi-structured in-depth interviews with stakeholders in Brazil and Poland to explore this puzzle. We argue that the WPS agenda has survived in these political contexts due the presence of key ‘femocrats’ within the state; the influence of international institutions; and the symbolic power that the WPS agenda gives to these countries on the world stage. As such, the article makes a key contribution to the literature on the WPS agenda and also bolsters the argument for a complication of the idea of gender ‘backlash’ – in domestic and international audiences, states are willing to adopt different attitudes to gender if it furthers their interests.

To ensure that public health services provide comprehensive and inclusive health care to the general population, it is important for countries to estimate how many of their citizens experience gender dysphoria and wish to receive specialized hormone treatment or gender-affirming surgery. The aim of this study was to estimate the prevalence of individuals with gender dysphoria seeking transgender health care in a public teaching hospital in southern Brazil. In this retrospective follow-up study, we analyzed the medical records and sociodemographic data of individuals aged > 15 years living in Rio Grande do Sul, Brazil, that enrolled in a specialized program to receive hormone therapy and gender-affirming surgery between 2000 and 2018. This study is the first to attempt estimating the prevalence of gender dysphoria in Rio Grande do Sul; it describes novel data on the clinical profile of individuals with gender dysphoria treated in a public hospital specialized in providing transgender health care. Prevalence estimates were calculated based on statewide annual population data in the study period. Of 934 identified individuals, 776 (601 trans women and 175 trans men) were included in this study. The overall prevalence of individuals with gender dysphoria was 9.3 per 100,000 individuals (95% CI: 8.6 to 9.8). Meanwhile, there were 15 trans women per 100,000 people (95% CI: 14 to 16) and 4.1 trans men per 100,000 people (95% CI: 3.5 to 4.8). There was a progressive increase in the number of people seeking hormone therapy and gender-affirming surgery during the study period. Future research is needed to determine the size of the trans population in other regions of Brazil and to expand the knowledge regarding gender dysphoria to allow for the development of effective public policies for people with gender dysphoria.

(1) Background: We aimed to estimate sexualized drug use (SDU) prevalence and its predictors among sexual and gender minorities. (2) Methods: We used an online and on-site survey to enroll sexual/gender minorities people between October–December/2020, and multivariate logistic regression to obtain SDU correlates. (3) Results: We enrolled 3924 individuals (280 transgender women [TGW], 3553 men who have sex with men [MSM], and 91 non-binary), 29.0% currently on pre-exposure prophylaxis (PrEP). SDU prevalence was 28.8% (95% confidence interval [CI] 27.4–30.2). TGW had 2.44-times increased odds (95%CI 1.75–3.39) of engaging in SDU compared to MSM, regardless of PrEP use. PrEP use (aOR 1.19, 95%CI 1.00–1.41), South/Southeast region (aOR 1.26, 95%CI 1.04–1.53), younger age (18–24 years: aOR 1.41, 95%CI 1.10–1.81; 25–35 years: aOR 1.24, 95%CI 1.04–1.53), white race/color (aOR 1.21, 95%CI 1.02–1.42), high income (aOR 1.32, 95%CI 1.05–1.67), binge drinking (aOR 2.66, 95%CI 2.25–3.14), >5 sexual partners (aOR 1.88, 95%CI 1.61–2.21), condomless anal sex (aOR 1.49, 95%CI 1.25–1.79), self-reported sexually transmitted infection (aOR 1.40, 95%CI 1.14–1.71), and higher perceived HIV-risk (aOR 1.37, 95%CI 1.14–1.64) were associated with SDU. (4) Conclusions: TGW had the highest SDU odds. SDU may impact HIV vulnerability among key populations and should be addressed in HIV prevention approaches.