Online Program

Stigma, syndemics and HIV risk in transgender women

Tuesday, November 5, 2013

Don Operario, PhD, Department of Behavioral and Social Sciences, Brown University, School of Public Health, Providence, RI
Mei-Fen Yang, Brown University, Providence, RI
Sari L. Reisner, MA, The Fenway Institute, Fenway Health and Harvard School of Public Health, Boston, MA
Mariko Iwamoto, MA, Public Health Institute, Oakland, CA
Tooru Nemoto, PhD, Public Health Institute, Oakland, CA
Background: Transgender women in the United States might be vulnerable to a “syndemic” of HIV-related health risk behaviors (unprotected anal intercourse, alcohol intoxication, and drug use). According to the Minority Stress Model, stigma and discrimination toward transgender women might contribute to greater risk for HIV-related syndemics.

Methods: Cross sectional survey of 191 transgender women recruited through purposive sampling.

Results: In multivariable analyses controlling for age, race/ethnicity, and income, we found that unprotected anal intercourse, alcohol intoxication, and illicit drug use were significantly intercorrelated, suggesting a “syndemic” among these behavioral health risks. In multivariable analyses controlling for sociodemographic and individual health characteristics, we found that stigma was independently associated with greater levels of unprotected anal intercourse, illicit drug use, and a composite index of the three risk behaviors.

Discussion: Evidence for HIV-related syndemics in transgender women bring attention to the need for multi-component interventions to address stigma and the social context of unprotected sex, alcohol intoxication, and drug use in transgender women.

Learning Areas:

Diversity and culture
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Define the concept of "syndemics" and apply this concept to HIV in transgender populations. Evaluate the role of stigma as a determinant of HIV-related syndemics in transgender women. Discuss public health strategies for addressing stigma and HIV-related syndemics among transgnder women.

Keyword(s): HIV Risk Behavior, Sexual Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was principal investigator of this research, conceptualized the analysis, and wrote the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.