Psychosocial factors and HIV-related risk behaviors among NYC Transgender youth

Although Transgender persons (TG) are particularly vulnerable to HIV infection and transmission, few studies have described psychosocial factors or other correlates of HIV risk behaviors in this population. We performed a retrospective chart review on 57 TG adolescents and young adults aged 15-23 years who received care at an inner-city Brooklyn clinic over a four-year period (2007-2011). An overwhelming majority of participants were male to female transgender (MTF, 93%); and of these, 66.7% engaged in anal receptive intercourse. Despite a high overall HIV prevalence (21.1%), only 55% of study participants reported consistent condom use. The majority of participants reported a history of unstable housing (60.8%), 38.6% had a family history of mental illness or substance abuse, and 27% admitted to a history of suicidality. The presence of a mental health diagnosis was significantly associated with a history of physical or sexual abuse [c ² (1) = 7.287, p=0.007], substance use showed a marginally significant association with suicidality [ c ²(1) =3.719, p=0.054] while family history of drug use was significantly associated with suicidality [ (c ²(1) = 3.866, p=0.049]. TG youth demonstrate a high prevalence of predisposing factors for high-risk behavior and a high prevalence of HIV infection. Culturally tailored prevention programs targeting NYC TG youth are therefore critical to HIV risk reduction efforts in this population.