Online Program

Relationships Between Substance Use and Unprotected Sex among Transwomen

Monday, November 2, 2015

Tooru Nemoto, PhD, Public Health Institute, Oakland, CA
Sachiko Suzuki, MPH, Health Intervention Projects for Underserved Populations, Public Health Institute, Oakland, CA
Mariko Iwamoto, MA, Public Health Institute, Oakland, CA
Background: Unprotected sex under the influence of substances has been investigated among MSM, but few studies have been conducted for transwomen whose HIV prevalence was reported high. 

Methods:  The 5-year Mariposa Project aims to reduce substance use and HIV risk behaviors for transwomen of color in San Francisco and Alameda County. A total of 213 transwomen were recruited based on purposive sampling and administered a structured questionnaire asking about substance use behaviors and psychosocial factors at baseline.

Results: Participants reported using alcohol or drugs before having sex with their primary (28%), casual (43%), and commercial partners (29%) and of these, they had engaged in unprotected receptive anal sex (URAS) with primary (42%), casual (31%), and commercial partners (17%).  Using drugs or alcohol before sex with a casual or commercial partner was associated with URAS (p<0.01).  Interestingly, using drugs or alcohol before sex with primary partners was not associated with URAS. Those who reported sex with casual or commercial partners under the influence of substances used alcohol (84%), marijuana (77%), methamphetamines (47%), crack (22%), and cocaine(26%) in the past 3 months. In addition, those who reported using substances before sex with casual or commercial partners had significantly lower levels of self-esteem than those who did not (p<0.05).

Conclusion: URAS with casual and commercial partners among transwomen will elevate their risk for HIV/STIs. HIV prevention intervention programs must address URAS in relation to substance use and partner types.

Learning Areas:

Assessment of individual and community needs for health education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the interaction between drug use and unprotected sex among transwomen. Discuss the correlates of HIV risk behaviors among transgender women of color. Identify and understand the relationship of drug use before sex and partner type.

Keyword(s): Lesbian, Gay, Bisexual and Transgender (LGBT), Behavioral Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked with Dr. Nemoto's group doing behavioral interventions for substance abuse, mental health and HIV/AIDS for the past year. I have been on several abstracts and manuscripts pertaining to transgender health that are published or in the process of being published. I have a strong background in research techniques and data analysis.
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: 3364.0: HIV and Substance Use