142nd APHA Annual Meeting and Exposition

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Location Matters: Correlates of HIV Risk Behaviors and HIV “Hot Spots” among Transgender Residents of Massachusetts

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 5:15 PM - 5:30 PM

Jaclyn White, MPH , Epidemiology Department, The Fenway Institute, Fenway Health, Boston, MA
Sari Reisner, ScD , Epidemiology/ The Fenway Institute, Harvard School of Public Health/ Fenway Health, Boston, MA
Matthew Mimiaga, ScD, MPH , Department of Epidemiology/ Department of Psychiatry, Harvard School of Public Health/ Harvard Medical School, Boston, MA
BACKGROUND: HIV surveillance data indicates that HIV infection typically clusters in specific geographic “hot spot” areas, suggesting the need for inclusion of geographic factors alongside traditional demographic and socio-behavioral risk factors when assessing HIV risk and allocating HIV prevention resources.

METHODS: In 2013, 445 transgender residents of Massachusetts completed an online (88%) and in-person (12%) survey assessing demographics, substance use, and sexual behaviors. A multivariable logistic regression model examined associations between race, alcohol consumption, unprotected sex and residing in Massachusetts “hot-spot” city with the highest HIV/AIDS prevalence.

RESULTS: Participants had a mean age of 32 (SD=12.9), 79% were White, 63% were assigned a female sex at birth, and 18% resided in an HIV hot-spot. About one-third (32%) reported binge drinking in the past 3-months (drinking five+ alcoholic beverages at one time). Eleven percent engaged in receptive anal sex with a male-born partner during their last sexual encounter, of which half indicated that they didn’t use a condom. Factors significantly associated with the increased odds of living in an HIV hot-spot included: non-white race/ethnicity (aOR=3.04; CI=1.26-7.32), binge drinking (aOR=2.31; CI=1.04-5.11), and unprotected receptive anal sex with a male-born partner at last sexual encounter (aOR= 4.30; CI=1.19-15.49).

CONCLUSION: Findings suggest that transgender people of color and those engaging in recent HIV risk behavior have a higher probability of residing in Massachusetts cities with the highest HIV/AIDS prevalence. Future research should explore the sexual networks and behavioral norms of transgender residents of hot-spot cities so that targeted HIV prevention programs may be developed.

Learning Areas:

Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the prevalence of self-reported substance use, sexual risk behavior and other HIV risk factors among a sample of transgender residents of Massachusetts Assess associations between between race, alcohol consumption, unprotected sex and residing in a Massachusetts city with the highest HIV/AIDS prevalence in a sample of transgender residents of Massachusetts

Keyword(s): HIV Risk Behavior, Lesbian, Gay, Bisexual and Transgender (LGBT)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a pre-doctoral researcher in the Department of Epidemiology at The Fenway Institute at Fenway Health. My research interests and experiences include the identification of HIV risk factors and HIV prevention and substance abuse intervention development for marginalized populations including sexual, gender and racial minorities.
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.