Adolescent gender-related abuse, androphilia, and HIV risk among transfeminine people of color in New York City

Introduction: Public health research has indicated extremely high HIV seroprevalence (13-63%) among low-income transfeminine (MTF) people of color of African, Latina, and Asian descent living in the U.S. Much of the high HIV seroprevalence has been attributed to participation in survival sex work and infection from primary male partners. Public health discourse has also often focused on health behavior change without understanding cultural contexts. In addition, negative mental health outcomes as comorbidities of HIV have also not been examined.

Methods: This paper combines two data sets. One set is based on an 18-month (2005-06) ethnographic study of HIV risk among MTF communities in NYC (N=50, 120 hours of participant observation). The other set is a five-year (2004-09) National Institutes of Health-funded longitudinal quantitative study examining MTF people in NYC (baseline N=600, N=275 followed for 3 years).

Results and Discussion: Transfeminine people of color are at much higher HIV risk than white transfeminine people. Depression is high among all transfeminine people, but for transfeminine people of color, depression is strongly correlated with gender-related abuse experienced as adolescents. Depression may be one of several effects resulting from trauma experienced during adolescence. Depression and other traumatic effects may also be highly correlated with HIV risk within androphilic relationships. A greater understanding of adolescent gender-related abuse among transfeminine people of color may be essential for more efficacious HIV prevention.