title: Prevalence and correlates of substance use among trans female youth ages 16-24 years in the San Francisco Bay Area.
abstract: BACKGROUND
  Substance use is highly prevalent among transgender (trans*) females and has been associated with negative health outcomes, including HIV infection. Little is known about psychosocial risk factors that may influence the onset of substance use among trans*female youth, which can contribute to health disparities during adulthood.
  
  
  METHODS
  We conducted a secondary data analysis of a study on HIV risk and resilience among trans*female youth (N=292). Prevalence of substance use was assessed and multivariable logistic regression models were used to examine the relationship between posttraumatic stress disorder (PTSD), psychological distress, gender-related discrimination, parental drug or alcohol problems (PDAP) and multiple substance use outcomes.
  
  
  RESULTS
  Most (69%) of the trans*female youth reported recent drug use. In multivariable analyses, those with PTSD had increased odds of drug use [AOR=1.94 (95% CI=1.09-3.44)]. Those who experienced gender-related discrimination had increased odds of drug use [AOR=2.28 (95% CI=1.17-4.44)], drug use concurrent with sex [AOR=2.35 (95% CI=1.11-4.98)] and use of multiple drugs [AOR=3.24 (95% CI=1.52-6.88)]. Those with psychological distress had increased odds of using multiple heavy drugs [AOR=2.27 (95% CI=1.01-5.12)]. Those with PDAP had increased odds of drugs use [AOR=2.62 (95% CI=1.43-4.82)], drug use concurrent with sex [AOR=2.01 (95% CI, 1.15-3.51)] and use of multiple drugs [AOR=2.10 (95% CI=1.22-3.62)].
  
  
  CONCLUSIONS
  Substance use is highly prevalent among trans*female youth and was significantly associated with psychosocial risk factors. In order to effectively address substance use among trans*female youth, efforts must address coping related to gender-based discrimination and trauma. Furthermore, structural level interventions aiming to reduce stigma and gender-identity discrimination might also be effective.
authors.affiliation: Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States.
authors.forename: Chris
authors.initials: C
authors.lastname: Rowe
authors.affiliation: Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States.
authors.forename: Glenn-Milo
authors.initials: GM
authors.lastname: Santos
authors.affiliation: Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States.
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
authors.affiliation: Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States. Electronic address: erincwilson@gmail.com.
authors.forename: Erin C
authors.initials: EC
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology; D005260:Female; D005783:Gender Identity; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D063106:Transgender Persons / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult; D008297:Male
keywords: Discrimination; Health disparities; Posttraumatic stress disorder; Substance use; Trans*female youth; Transgender