Role of Structural Barriers in Risky Sexual Behavior, Victimization and Readiness to Change HIV/STI-related Risk Behavior among Transgender Women
Methods: Between 2007-2008, a community-based sample of 63 transgender women were recruited for participation in a HIV/STI risk reduction intervention in New York City. Linear regression analyses tested the association between structural barriers (lack of transportation, insufficient housing, food insecurity, access to medical care and employment) and (1) number of partners engaged in condomless anal sex during the previous 3 months (includes main, casual, paying, and trade partners), (2) verbal, physical and sexual abuse, and (3) readiness to change HIV/STI risk behavior. Logistic regression and chi-square analyses tested whether experiencing any or specific structural barriers distinguished HIV-positive and negative transgender women.
Results: Experiencing structural barriers was significantly associated with an increased number of condomless anal sex acts (p = .002), lifetime and recent victimization (p = .0001) and a decreased readiness to change HIV-related risk behavior (p = .014). Experiencing structural barriers did not distinguish HIV- positive and negative transgender women.
Conclusion: HIV-negative and positive transgender women experience similar structural barriers that are associated with HIV/STI risk behavior. Structural-level interventions are needed to address this elevated risk among this underserved and hard-to-reach population.
Learning Areas:Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences
Explain and apply the concept of structural barriers to HIV/STI-risk reduction to transgendered women. Describe the association between structural barriers and risky sexual behaviors, readiness to change HIV/STI-related risk behavior and abuse among a sample of HIV positive and negative transgender women.
Keyword(s): HIV/AIDS, Vulnerable Populations
Qualified on the content I am responsible for because: I am a Behavioral Scientist at the CDC, Division of HIV/AIDS Prevention where I have published several articles on HIV risk among high-risk and vulnerable populations and evaluated the efficacy of behavioral interventions for populations at the highest risk of HIV acquisition or transmission.
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.