142nd APHA Annual Meeting and Exposition

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299477
Non-Prescribed Hormone Use and HIV Risk among Transgender Women

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 10:50 AM - 11:10 AM

Tooru Nemoto, PhD , Health Intervention Projects for Underserved Populations, Public Health Institute, Oakland, CA
Mariko Iwamoto, MA , Health Intervention Projects for Underserved Populations, Public Health Institute, Oakland, CA
Taylor Cruz, BS , Health Intervention Projects for Underserved Populations, Public Health Institute, Oakland, CA
Sachiko Suzuki, MPH , Health Intervention Projects for Underserved Populations, Public Health Institute, Oakland, CA
Audio (mp3) recording Recorded Presentation (mp4)
Background: Transwomen face social and economic barriers in accessing transgender competent health care, including cross-gender hormonal therapy. Therefore, many transwomen seek non-prescribed hormones (NPHs) instead of obtaining prescribed hormones (PHs) under the guidance of a health care provider. Little is known about the health consequences of NPH use among transwomen in relation to other risk behaviors and their sociocultural context.

Methods: Eligible transwomen were recruited based on purposive sampling through community venues and collaborating AIDS service organizations in San Francisco and Oakland. A total of 573 transwomen (235 African American, 110 Asian and Pacific Islander, 110 Latina, and 118 Caucasians) were individually interviewed using a structured questionnaire in English or Spanish.

Results: In our sample, 46% reported lifetime NPH use, 43% reported only PH use, and 11% reported never having taken hormones. The majority of those using NPHs reported taking estrogen pills (92%) and obtained them from Mexico (49%), a friend (75%), non-prescription street source (28%), or other sources (11%). Compared to participants only using PHs, participants using NPHs were significantly more likely to have engaged in sex work, to inject hormones, and to use alcohol or drugs before having sex with customers.

Conclusion: The prevalence of NPH use is high among transwomen. NPH use is associated with sex work and other HIV risk behaviors. Future research into the sociocultural context of NPH is needed to reduce NPH use and promote health and well-being for transwomen.

Learning Areas:

Advocacy for health and health education
Diversity and culture
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
Compare HIV risk factors among transwomen using NPHs with those using only PHs. Identify common forms of NPH use and methods of obtainment. Understand the importance of cross-gender hormones for transgender women’s access to care and social experience.

Keyword(s): Women and HIV/AIDS, Vulnerable Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Nemoto received his Ph.D. in Psychology from NYU in 1988. He has over 25 years of experience in conducting community-based intervention studies and projects particularly in substance abuse and HIV/AIDS treatment and prevention for under-served and stigmatized populations, such as transgender people, MSM, sex workers, and Asian drug users. He also published over 50 publications in peer-reviewed journals, conducted more than 100 presentations and invited lectures.
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.

Back to: 5091.0: Women's health across the lifespan