Transgender HIV Behavioral Surveillance (THBS) pilot study in Houston, TX

Background: The CDC's National HIV Behavioral Surveillance (NHBS) system was created to monitor behaviors associated with acquiring HIV infection and experiences with HIV testing and prevention services among high-risk populations. Although male-to-female (MTF) transgenders are vulnerable to acquiring HIV, they are underserved by current HIV prevention efforts and not included in previous NHBS cycles. Objectives: In 2009, CDC funded this pilot study to explore the feasibility of using respondent driven sampling (RDS) to collect HIV-behavioral surveillance data from minority MTF transgender persons. Methods: Consenting participants recruited through RDS completed a risk behavior survey using audio computer assisted self interviews (ACASI). Results: Fifty-nine participants completed the survey. Half of the sample reported being homeless in the last 12 months. 75% reported receptive anal intercourse at their last sexual encounter and only half of those reported condom use. More than half of the sample reported using the Internet for online dating and 42% used the Internet for sex work. Sixty percent reported being under physician care for hormone therapy, although 35% of our self-reported HIV negative sample had not had an HIV test in the last 2 years. Conclusions: These findings reveal significant HIV risk behaviors for this population in Houston as well as missed opportunities for medical personnel to offer HIV testing to a high-risk population. Implications: These data are important to direct and evaluate HIV prevention efforts and are expected to inform the development of a national protocol to collect HIV related behavioral data from the MTF transgender individuals.