About

Madina Agénor is an Associate Professor in the Department of Behavioral and Social Sciences at Brown University. She also holds affiliations with the program in Science, Technology, and Society and the concentration in Gender and Sexuality Studies at the Pembroke Center. Her interdisciplinary research employs intersectional, mixed-methods, and community-engaged approaches to explore how structural and social factors—including laws, policies, institutional practices, community resources, and interpersonal interactions—shape health inequities across diverse social groups at the intersections of race, ethnicity, class, gender, and sexuality. Her work situates health disparities within their historical, social, and policy contexts and emphasizes how marginalized communities resist oppressive structures through collective efforts and practices of care. Dr. Agénor's academic background includes a Doctor of Science in Social and Behavioral Sciences with a focus on Women, Gender, and Health from Harvard T.H. Chan School of Public Health, a Master of Public Health in Sociomedical Sciences from Columbia University Mailman School of Public Health, and a bachelor's degree in Community Health and Gender Studies from Brown University. She completed postdoctoral training in cancer prevention equity at Dana-Farber Cancer Institute and has held faculty positions at Harvard University, Tufts University, and Wellesley College. Her scholarly contributions include serving on the Editorial Advisory Board of Social Science & Medicine and the Editorial Collective of Feminist Studies, reflecting her active engagement in advancing research on health disparities, gender, and social justice.

Research topics

• Sociology
• Psychology
• Political Science
• Medicine
• Social psychology
• Demography
• Gender studies
• Environmental health

Selected publications

• HIV diagnostic implementation in the Dominican Republic: an in-depth qualitative context analysis for health technology developers

  BMJ Open · 2026-02-01

  articleOpen access

  OBJECTIVES: To understand the political, economic, social and technological facilitators and barriers in obtaining an HIV diagnosis to inform implementation strategies for HIV diagnostics in the Dominican Republic (DR). DESIGN: In-depth, semi-structured qualitative interviews. SETTING: A high complexity public hospital in Santiago de los Caballeros, DR. PARTICIPANTS: A convenience and purposive sample of 36 internal medicine physicians and laboratory personnel involved in sample collection, sample analysis or oversight of biological sample analysis. RESULTS: Using the Social Ecological Model, our results highlighted several interrelated barriers and facilitators to sample analysis at the individual (patient), interpersonal (interactions between laboratory personnel, physicians and patients), organisational (the hospital), community (Santiago de Los Caballeros) and societal (the DR) levels. Some key findings include the importance of psychological support in receiving an HIV diagnosis, how spoken language can be a barrier to care, how inconsistent access to laboratory supplies is a barrier for patients, laboratory personnel and clinicians, and the importance of government public health investment. CONCLUSIONS: Employing qualitative methods to investigate a bioengineering challenge yielded rich data on the sociotechnical implementation context of HIV diagnostics in the DR. Several context-relevant suggestions were developed for HIV diagnostic developers which include incorporating psychological support into the diagnosis workflow, delivering information in multiple languages (ie, Haitian Creole and Spanish) and with non-stigmatising phrasing, working with the public sector to develop and implement technologies, and reducing the supply chain reliance on high-income countries to lessen delays in care. These findings can apply to other types of health technologies and settings and demonstrate the importance of utilizing human-centered design to understand implementation context and promote global health equity in health technology development and adoption.

  PublisherDOI

• “It Was Like a Baptism by Fire:” Sexual and Reproductive Healthcare Providers’ Training Experiences Related to the Provision of Care to Black and Latina Women Who Use Substances in the United States

  Community Health Equity Research & Policy · 2025-12-24

  articleSenior author

  Black and Latina cisgender and transgender women who use substances face adverse sexual and reproductive health (SRH) outcomes due to intersecting forms of discrimination and limited access to high-quality SRH services. Insufficient research has explored healthcare providers' views and experiences related to delivering SRH care to multiply marginalized women, especially the role of training in shaping their attitudes and practices. Using purposive sampling, we conducted online, in-depth interviews with 20 SRH care providers in Massachusetts and Rhode Island in August-November 2023 to elucidate how their training influenced their provision of SRH care to Black and Latina cisgender and transgender women who use drugs and identify the strategies they used to address the limitations of their formal training. Using intersectionality-informed thematic analysis, we found that most providers expressed dissatisfaction with their clinical education, which failed to address how racism, transphobia, and substance use stigma simultaneously influenced SRH outcomes and care. Further, many reported that the training needed to provide high-quality SRH care to Black and Latina cisgender and transgender women who use drugs largely occurred outside of their formal education, but that burnout, time constraints, and lack of reimbursement undermined their ability to obtain additional training and deliver tailored care. Providers also described how their professional and personal backgrounds influenced their practices and noted that specialized SRH education, working in person-centered care settings, and sharing social identities with patients facilitated their provision of high-quality SRH care to Back and Latina women who use drugs. Medical and nursing programs should incorporate training on intersectional discrimination and facilitate the enrollment of students with multiple minoritized social identities to advance SRH equity and justice.

  PublisherDOI

• Transgender and other gender minoritised assigned female at birth young adults’ perceptions of and experiences with human papillomavirus vaccination

  Culture Health & Sexuality · 2025-06-24

  articleSenior author

  Transgender and other gender minoritised individuals have lower human papillomavirus (HPV) vaccine completion rates than the general population, and little is known about how gender minoritised young adults perceive and experience HPV vaccination. The aim of this study was to characterise perceptions of, experiences with, and recommendations to facilitate access to HPV vaccination among transgender and other gender minoritised assigned female at birth (AFAB) young adults in the greater Boston area. In 2020, in-depth interviews were conducted in Boston with a purposive community sample of 34 transgender and other gender minoritised AFAB young adults aged 18-26. Thematic analysis was used to examine participants' HPV vaccine perceptions and experiences. Participants reported that gendered representations of the HPV vaccine, lack of relevant HPV vaccine education, and previous negative experiences with healthcare led to low prioritisation of, and at times avoidance of, HPV vaccination. Participants had inadequate and at times inaccurate understandings of the HPV vaccine and called for increased education of the public and healthcare providers on HPV vaccination for this vulnerable population. Targeted interventions providing transgender and other gender minoritised AFAB individuals with culturally responsive care and tailored information about the HPV vaccine are needed.

  PublisherDOI

• Association Between Health Care Discrimination and Medical Mistrust Among Black Assigned Female at Birth Adults with Minoritized Sexual and Gender Identities in the United States

  LGBT Health · 2025-02-06 · 6 citations

  articleOpen accessSenior author

  Purpose: Black sexually and gender minoritized (SGM) people who were assigned female at birth (AFAB) experience compounding health care inequities, barriers to equitable care, and disproportionately adverse health outcomes. Given prior literature indicating that both experienced and/or anticipated reported health care discrimination and medical mistrust may shape these health care experiences of Black SGM AFAB people, we sought to investigate the specific interplay between these two factors to bolster understanding of their relationship.

  PublisherOA PDFDOI

• Multilevel syndemic profiles impacting optimal ART adherence among trans women living with HIV in Mumbai and New Delhi, India: A latent Class analysis

  International Journal of Transgender Health · 2025-07-03 · 1 citations

  article

  Background: Antiretroviral therapy (ART) adherence is essential for maintaining viral suppression and reducing HIV transmission risk. However, data on adherence rates among trans women living with HIV in India are scarce, hindering effective intervention efforts. Understanding multilevel syndemic factors, including harmful drinking, depressive symptoms, HIV, and trans women-related stigma, and access to gender-affirmative care, is crucial for improving HIV treatment outcomes in this population. Methods: Trans women living with HIV (N=150) in Mumbai and New Delhi, India, completed a one-time self-reported assessment of sociodemographic and psychosocial factors and ART adherence and provided recent viral load test results in the ART booklet. Latent class analysis (LCA) identified multilevel syndemic classes. Then, in logistic regression models, we assessed the relationship between syndemic classes and optimal ART adherence (defined as 90% or higher adherence as prescribed). Results: Optimal ART adherence (defined as 90% or higher adherence to prescribed doses) was reported by 63% of participants. Among those with suboptimal adherence (n=93), common barriers included lack of medication while traveling, forgetting, and alcohol use. The LCA identified two syndemic classes: Class 1, characterized by unidimensional stigma and moderate multilevel syndemic barriers, and Class 2, characterized by intersectional stigma and high multilevel syndemic barriers. In the bivariate analysis, participants in Class 2 had significantly lower odds of optimal ART adherence [OR: 0.27 (95% CI: 0.11 - 0.61), p = 0.003]. After controlling for potential confounders (i.e., city, monthly income, stable housing, and history of sex work), participants in Class 2 still had significantly lower odds of optimal ART adherence [aOR: 0.26 (95% CI: 0.09 - 0.64), p = 0.009]. Conclusion: Findings highlight substantial disparities in ART adherence among trans women living with HIV in India, driven by intersectional stigma and multilevel syndemic barriers. Addressing these factors, particularly HIV and trans women-related stigma, is critical for improving ART adherence and HIV treatment outcomes in this population.

  PublisherDOI

• Advancing equity in cervical cancer screening for sexual and gender minoritized people assigned female at birth (SGM AFAB) in the United States: recommendations from healthcare equity leaders

  Reproductive Health · 2025-07-29 · 3 citations

  articleOpen accessSenior author

  Sexual and gender minoritized (SGM) people, including but not limited to lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people assigned female at birth (AFAB), experience a greater burden of cervical cancer relative to their heterosexual and cisgender counterparts. However, they face pronounced systemic barriers to regular cervical cancer screening. Although evidence-based clinical guidelines play an integral role in the implementation of preventive measures, existing United States (U.S.) cervical cancer screening guidelines do not consider the specific experiences, needs, and contexts of SGM AFAB people concerning cervical cancer outcomes nor cervical cancer screening. Thus, it is imperative to determine how cervical cancer screening guidelines can be revised to better address the unique and specific cervical cancer prevention needs of SGM AFAB people in the U.S. We conducted virtual key informant interviews to elicit recommendations for advancing SGM health equity in developing and implementing cervical cancer screening guidelines from healthcare equity leaders (N = 18), including half with expertise in SGM AFAB people’s healthcare. Interviews were analyzed using a template-style thematic analysis approach to develop themes and sub-themes. Healthcare equity leaders provided three key recommendations for advancing SGM health equity in the development and implementation of U.S. cervical cancer screening guidelines. Healthcare equity leaders recommended prioritizing community and person-centered strategies, including engaging SGM communities in the development of the guidelines and using SGM-affirming approaches in their implementation. Revising language that (re)produces harmful normative and exclusionary assumptions about gender and sexuality in the context of cervical cancer screening guidelines was also recommended. Lastly, leaders recommended a range of strategies to mitigate systemic barriers to cervical cancer screening among SGM AFAB people, including collecting and utilizing representative data on SGM AFAB people’s needs, experiences, and contexts to develop the guidelines and ensure cultural responsiveness in the delivery of cervical cancer screening to SGM AFAB people across healthcare systems. This study's findings can contribute to improving and advancing health equity in cervical cancer screening for SGM AFAB populations through the community-centered development of inclusive, evidence-based guidelines and their person-centered implementation in clinical settings. Sexual and gender minoritized (SGM) people, including but not limited to lesbian, gay, bisexual, transgender and queer (LGBTQ+) people assigned female at birth (AFAB) experience a greater burden of cervical cancer relative to their heterosexual and cisgender counterparts; yet, they face pronounced barriers to regular cervical cancer screening. Although clinical guidelines play an integral role in the implementation of preventive measures, including screening for cervical cancer, existing United States (U.S.) cervical cancer screening guidelines do not take into account the specific experiences, needs, and contexts of SGM AFAB people. Thus, it is imperative to determine how cervical cancer screening guidelines can be improved to better address the unique and specific cervical cancer prevention needs of SGM AFAB people in the U.S. We conducted virtual key informant interviews with healthcare equity leaders (N = 18) in medicine, public health research, and policy to learn more about the ways in which cervical cancer screening guidelines could better meet the needs of SGM AFAB people in the U.S. These healthcare equity leaders recommended (1) including the SGM AFAB community in the development of the guidelines (2), avoiding harmful assumptions about SGM people and cervical cancer risk in the guidelines and (3) implementing the guidelines in ways that reduce barriers and increase cultural responsiveness in cervical cancer screening among SGM AFAB people. These valuable insights from healthcare equity leaders provide actionable insights for improving SGM health equity in the development and implementation of U.S. cervical cancer screening guidelines.

  PublisherOA PDFDOI

• Controlling Partner Dynamics in Transgender/Nonbinary Young Adults’ Romantic Relationships: Exploring the Roles of Cissexism-Related Beliefs and Material-Need Insecurity

  2025-03-14

  preprintOpen access

  Controlling partner dynamics—when a person’s sexual or romantic partner exerts disproportionate control over their behavior and/or joint decisions—can adversely impact sexual and mental health. For transgender and/or nonbinary (TNB) young adults, cissexism—the system of power relations that marginalizes TNB people in favor of cisgender people—may contribute to controlling partner dynamics. However, mechanisms linking cissexism to controlling partner dynamics remain underexplored. Using data from a cross-sectional online survey of romantically partnered U.S. TNB young adults (N=393; 18-30 years old; 50% nonbinary; 56% people of color), we tested two mediation pathways from interpersonal cissexism to controlling partner dynamics: (1) a cissexism-related beliefs pathway, in which cissexist rejection contributes to beliefs that may cause young adults to feel socially and emotionally dependent on romantic partners, and (2) a material-need insecurity pathway, in which cissexist discrimination contributes to material-need insecurity, leaving young adults dependent on romantic partners for needs such as food and housing. We tested individual paths using generalized linear models, then tested mediation pathways using natural effects mediation analysis, adjusting for age, gender, race and ethnicity, sexual orientation, and partner gender. The cissexism-related beliefs pathway was not supported. However, results supported the material-need insecurity pathway—namely, cissexist discrimination was positively associated with controlling partner dynamics (b=0.15; P=.012), with a significant joint indirect effect via material-need insecurity (food insecurity and housing instability; b=0.05; P=.022). Reducing TNB young adults’ vulnerability to controlling partner dynamics may require structural changes (e.g., laws, policies, norms) to prevent cissexist discrimination and material-need insecurity.

  PublisherOA PDFDOI

• Weight-Based Health Care Discrimination and Cervical Cancer Screening Among Black Sexual and Gender Minoritized Assigned Female at Birth Adults in the United States

  Health Equity · 2025-01-13 · 3 citations

  articleOpen accessSenior author

  Introduction: Black sexual and gender minoritized (SGM) people assigned female at birth (AFAB) face notable barriers to cervical cancer screening, including racism, heterosexism, and cisgenderism. Although weight-based discrimination is prevalent in the United States and may compound other forms of discrimination, no study has examined the association between weight-based discrimination in health care settings and Pap test use among Black SGM AFAB. Materials and Methods: = 135) and used multivariable logistic modeling to analyze the association between weight-based health care discrimination and Pap test use, adjusting for demographic, socioeconomic, and health care factors. Results: = 54) of respondents had ever received a Pap test in their lifetime and in the last 3 years, respectively. Respondents who had experienced weight-based health care discrimination had significantly lower adjusted odds of having ever received a Pap test in their lifetime (odds ratio [OR] = 0.10; 95% confidence interval [CI]: 0.02-0.40) and in the last 3 years (OR = 0.07; CI: 0.01-0.31) compared with those who had never experienced such discrimination. Discussion: Additional research is needed to elucidate the unique experiences of specific subgroups of Black SGM people and to inform policies, norms, and practices that mitigate the occurrence and effects of weight-based health care discrimination among Black SGM people in the context of cervical cancer screening and other health services.

  PublisherDOI

• Benefits of and Recommendations for Asynchronous Online Focus Group Methodology for Sexual and Reproductive Health Research with Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual, and Other Sexuality- and Gender-Expansive People with a Cervix

  LGBT Health · 2025-10-07

  articleSenior author

  Purpose: This study aimed to characterize benefits of asynchronous online focus groups (AOFGs) for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexuality- and gender-expansive (LGBTQIA+) young adults with a cervix and to identify strategies for maximizing those benefits and optimizing data collection in order to increase equitable representation of this population in health research. Methods: From March to September 2022, we conducted six gender-stratified AOFGs with cisgender women, nonbinary people, and transgender men with a cervix ages 21–29 living in Massachusetts and Rhode Island. Participants completed a questionnaire to evaluate AOFG procedures and experiences. Based on these data and our observations of AOFG engagement, we developed and evaluated strategies to optimize both data collection and participant benefit. Results: AOFGs provided participants with informational and instrumental support, connection through shared experiences, and opportunity for introspection. Participants expressed a strong desire for social interaction within AOFG discussions, and we identified several strategies that were effective in promoting engagement and interaction in AOFGs. Conclusion: AOFGs can facilitate inclusion in research of LGBTQIA+ individuals for whom other data collection methods are inaccessible, and may offer direct social and emotional benefits to participants. Promoting social interaction among participants is essential for optimizing these benefits. These findings offer important insight for AOFG methodology as a means of increasing equitable representation of LGBTQIA+ people in health research while offering direct and immediate benefits to participants.

  PublisherDOI

• Transgender Women in India: A Syndemic and Intersectional Framework Addressing HIV Care Gaps

  American Journal of Public Health · 2025-05-01 · 5 citations

  articleOpen access

  The prevalence of HIV among transgender women (TGW) in India is disproportionately high, estimated at 4% to 8% in comparison with the national average of 0.2%. Despite free antiretroviral therapy (ART) provided by the government, TGW encounter multilevel barriers—including stigma, poverty, and lack of gender-affirming care—that hinder HIV care access and retention. Existing behavioral frameworks fail to address the compounded effects of systemic oppression on the health of TGW with HIV in India. We present a conceptual framework integrating syndemic theory and intersectionality to examine structural and syndemic factors shaping HIV care barriers. Informed by key informants—including TGW with HIV, community leaders, health providers, and Indian researchers—the framework highlights how systemic marginalization, particularly through discriminatory policies, shapes social position and exacerbates inequities in HIV care outcomes. It also underscores the role of community mobilization and collective action in overcoming these barriers. The framework provides a foundation for interventions tailored to the needs of TGW. By centering community-driven strategies and addressing structural inequities, it offers a pathway to improve HIV care engagement and health outcomes among TGW in India. ( Am J Public Health. 2025;115(8):1245–1253. https://doi.org/10.2105/AJPH.2025.308046 )

  PublisherOA PDFDOI

Frequent coauthors

• Allegra R. Gordon

  Boston Children's Hospital

  93 shared

• S. Bryn Austin

  Boston Children's Hospital

  79 shared

• Jennifer Potter

  Beth Israel Deaconess Medical Center

  68 shared

• S. Bryn Austin

  Boston Children's Hospital

  60 shared

• Brittany M. Charlton

  Harvard Pilgrim Health Care

  59 shared

• Sarah M. Peitzmeier

  University of Michigan–Ann Arbor

  46 shared

• Sebastien Haneuse

  42 shared

• Sari L. Reisner

  University of Michigan–Ann Arbor

  33 shared

Education

• Ph.D., Social and Behavioral Sciences with a concentration in Women, Gender, and Health

  Harvard T.H. Chan School of Public Health

• Other, Sociomedical Sciences

  Columbia University Mailman School of Public Health

• B.A., Community Health and Gender Studies

  Brown University