Body composition in transgender women living with HIV/AIDS: a discussion of changes that impact on the assessment of nutritional status/Composicao corporal em mulheres transgenero vivendo com HIV/AIDS: uma discussao das transformacoes que interferem na avaliacao do estado nutricional

• Published in: Demetra: Alimentação, Nutrição e Saúde Vol. 11; no. S1; p. 1213
• Main Authors: Goncalves, Juliana Lauar, de Aguiar Cardoso, Claudia Santos, Bacelo, Adriana Costa, Santo, Raquel Espirito, de Almeida, Cristiane Fonseca, da Silva, Paula Simplicio, de Brito, Patricia Dias
• Format: Journal Article
• Language: English
• Published: Universidade do Estado do Rio de Janeiro- Uerj 15.12.2016
• Subjects: Brasil
• ISSN: 2238-913X; 2238-913X
• DOI: 10.12957/demetra.2016.22542

The clinical practice in care of transgender woman living with HIV/AIDS has drawn attention to the consequences of gender transformation procedures in the evaluation of body composition. Transgender women are people who were attributed as being men at birth, but identify themselves as women and claim for the social and legal recognition as women. In seeking for feminization, these people are likely to make use of silicone gels, hormone therapy or even harmful procedures such as silicone oil injection. These procedures result in anthropometric and body compartment changes such as the ones observed in subcutaneous adipose tissue, bone and lean body mass. In some cases, there is the occurrence of prostatic volume reduction and development of lobular and acinar breasts. In the context of HIV infection, this scenario is even more difficult to handle, since the treatment with antiretroviral, in some cases, could generate adverse reactions such as lipodystrophy. Lipodystrophy is characterized by changes in body fat distribution (lipoatrophy and lipohypertrophy) and must be considered in the body composition evaluation of this population. Because of the considerable vulnerability of transgender women with HIV infection, the World Health Organization recommends the adoption of specific actions of prevention, treatment and health care for this population. Therefore, in the present work, we intend to start thinking about the challenges to nutrition evaluation of transgender women living with HIV/AIDS. Keywords: Transgender. Silicone. Lipodystrophy. Body composition, HIV. A pratica clinica no atendimento de mulheres transgenero vivendo com HIV/AIDS despertou o olhar sobre as consequencias dos procedimentos para a adequacao ao genero autodeterminado no processo de avaliacao da composicao corporal. Mulheres transgenero sao pessoas que, ao nascer, receberam a atribuicao de homem, mas se autoidentificam e reivindicam o reconhecimento social e legal como mulheres. Em busca da feminilizacao, podem vir a fazer uso de geis de silicone, de terapia hormonal ou ate mesmo de procedimentos nocivos, como injecao de oleo de silicone. Esses procedimentos resultam em alteracoes antropometricas e modificacoes dos compartimentos corporais, como o tecido adiposo subcutaneo, massa ossea e massa magra. Ocorrem tambem, em alguns casos, especificidades, como a reducao do volume prostatico e o desenvolvimento lobular e acinar das mamas. O panorama e dificultado ainda no contexto da infeccao pelo HIV, cujo tratamento antirretroviral, em alguns casos, tem como reacao adversa a lipodistrofia. A lipodistrofia e caracterizada por alteracoes na distribuicao de gordura corporal (lipoatrofia e lipo-hipertrofia) e deve ser considerada na avaliacao da composicao corporal dessa populacao. Diante da grande vulnerabilidade de mulheres transgenero pela infeccao com o HIV, a OMS recomenda que sejam adotadas medidas especificas de prevencao, tratamento e servicos de saude para essa populacao. Portanto, no presente trabalho pretendemos iniciar a reflexao sobre os desafios para a avaliacao nutricional de mulheres transgenero vivendo com HIV/AIDS. Palavras-chave: Transgenero. Silicone. Lipodistrofia. Composicao corporal, HIV.