In Guatemala, a concentrated epidemic within a highly stigmatizing social context creates an environment fraught with challenges for reaching, testing, and linking vulnerable men who have sex with men (MSM) and transgender women (TW) with HIV testing and care. As part of USAID’s Combination Prevention Program in Guatemala, the Pan American Social Marketing Organization commissioned an ethnographic study in 2016-2017 to understand the sexuality, identity construction, health care seeking behaviors, and MSM/TW-health provider relationships to design consumer-focused strategies to facilitate access to HIV services. This ethnography was conducted in the two Guatemalan Departments with the highest HIV prevalence (Guatemala and Escuintla) among a sample of 24 MSM and 26 TW. The study included in-depth interviews that integrated complementary data collection instruments. Results were validated in a focus group with the target population.
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