Thick Trust, Thin Trust, and HIV among Transwomen of Color in New York City

Introduction: African American and Latina transwomen (male-to-female transgender people) have been found to have very high HIV seroprevalence nationally, and in New York City almost half are HIV positive. Transwomen of color are in the midst of an HIV epidemic, and greater knowledge and understanding about transwomen of color social networks may provide relevant information towards more effective interventions and policies.

Methods: These data come from a mixed-methods study that examined low-income trans/gender-variant people of color who attended transgender support groups at harm reduction programs in New York City. The study was conducted from 2011-12, with a total N=34. The qualitative portion was derived from six focus group interviews that were audio-taped and transcribed. The quantitative portion was derived from a survey that was administered at the focus groups.

Results and Discussion: 45% were Latina, 39% were Black, 55% had a high school education or less, and 46% reported living with HIV. Membership in these support groups was often drawn from already-established social networks, and support groups also strengthened supportive connections between transwomen of color. Among two of the groups there was evidence of extremely strong connections that resembled alternative kinship structures. Concerns were frequently raised over experiencing structural and interpersonal violence and possible deportation. Social support was often in the form of “thick trust” (bonding/sharing) and “thin trust” (information dissemination). Both thick and thin trust relationships may provide opportunities for expanded HIV prevention. HIV prevention, however, needs to be implemented within other serious concerns of these transwomen.