title: Non-medical use of prescription drugs and HIV risk behaviour in transgender women in the Mid-Atlantic region of the United States.
abstract: Male-to-female transgender women (TGW) experience high rates of substance use and HIV. A recent substance use trend is the use of prescription medication without a doctor's consent. No research to date has examined the associations between this non-medical use of prescription drugs and HIV risk behaviour in TGW. In the present study, TGW recruited from community venues (N = 104) in the Mid-Atlantic region of the United States completed surveys assessing demographic information, non-medical use of prescription drugs, other substance use, injection practices and sexual risk behaviour. Twenty-four per cent of the sample reported lifetime non-medical use of prescription drugs across the following categories: analgesics (21.2%), anxiolytics (14.4%), stimulants (12.5%) and sedatives (8.7%). Participants reporting non-medical use of prescription drugs were more likely to report other substance use, needle use to inject drugs, injecting silicone and sharing needles. In multivariable analyses, non-medical use of prescription drugs was associated with unprotected sex, sex after engaging in substance use, and commercial sex work, after controlling for demographic factors. Self-esteem and social support from family served as protective factors for non-medical use of prescription drugs. HIV-prevention programmes focused on TGW in the United States may wish to expand their assessment of substance use to include the use of prescription medications without a physician's consent.
authors.affiliation: Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA Institute for Women's Health, Virginia Commonwealth University Richmond, VA , USA ebenotsch@vcu.edu.
authors.forename: Eric G
authors.initials: EG
authors.lastname: Benotsch
authors.affiliation: St. Louis, College of Nursing, University of Missouri, St. Louis, MO, USA.
authors.forename: Rick S
authors.initials: RS
authors.lastname: Zimmerman
authors.affiliation: Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA Institute for Women's Health, Virginia Commonwealth University Richmond, VA , USA.
authors.forename: Laurie
authors.initials: L
authors.lastname: Cathers
authors.affiliation: Minority Health Consortium, Richmond, VA, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Pierce
authors.affiliation: Fan Free Clinic, Richmond, VA, USA.
authors.forename: Shawn
authors.initials: S
authors.lastname: McNulty
authors.affiliation: Virginia Department of Health, Richmond, VA, USA.
authors.forename: Ted
authors.initials: T
authors.lastname: Heck
authors.affiliation: Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Perrin
authors.affiliation: Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Snipes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D008297:Male; D008873:Mid-Atlantic Region / Q000453:epidemiology; D008875:Middle Aged; D016485:Needle Sharing; D063487:Prescription Drug Misuse / Q000009:adverse effects* / Q000706:statistics & numerical data; D012309:Risk-Taking; D012649:Self Concept; D011477:Sex Work; D012944:Social Support; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism / Q000523:psychology; D047568:Unsafe Sex; D055815:Young Adult
keywords: HIV; Transgender; commercial sex work; injection practices; prescription drug misuse; self-esteem; sexual behaviour; social support