Many male-to-female transgenders, including transsexuals, are at high risk of HIV infection. With funding from the Massachusetts Department of Public Health, AIDS Bureau, three of the authors conducted an anthropological needs assessment of Boston's transgendered community in collaboration with the fourth, Rebecca Durkee, the founder of a transgender community-based organization. Based on interviews and focus groups with transgenders and health and social service providers and participant observation in the Boston area, this paper analyzes the factors that contribute to HIV/AIDS risks among economically vulnerable male-to-female transgenders, many of whom engage in prostitution. Research data highlight the relationship between the process of social marginalization and enhanced HIV risks. They also underscore the inadequacy of analyzing risk either through behavioral and psychological characteristics of individuals or through the epidemiological concept of risk group or allied concepts such as bridge and core transmitters. Drawing on qualitative research findings, we advance a developmental and interactional model of HIV/AIDS and substance abuse risks among the transgenders in the study. Our research found that these risks among transgenders are shaped by (1) social stigmatization and related negative self-image, (2) economic vulnerability and related prostitution, and (3) the need for identity affirmation and the quest for a feminine body. While the concept of "group" confuses analysis of what contributes to risk, it can be important in the design of prevention strategies. In conclusion, we describe a group model of prevention in which building self-affirming social identities among transgenders helps to diminish risks for HIV/AIDS and substance abuse.
Learning Objectives: 1. Define the category of transgender. 2. Discuss structural factors that contribute to transgenders' risks for HIV/AIDS and substance abuse. 3. Describe community-based efforts by transgenders to reduce HIV infection and substance abuse
Keywords: Prevention, Community-Based Health Promotion
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Massachusetts Department of Public Health AIDS Bureau, Gender Identity Support Services for Transgenders (GISST), Transgender Community Center
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.