Prevalence and Correlates of HIV Infection and HIV Testing Among Transgender Women in Jamaica.
Transgender women are overrepresented in the Caribbean HIV epidemic. The study objective was to examine correlates of HIV infection and HIV testing among transgender women in Jamaica. We implemented a cross-sectional survey with transgender women in Kingston and Ocho Rios, Jamaica. We conducted multivariable logistic regression to identify factors associated with HIV testing and HIV infection. Among 137 transgender women [mean age 24.0; standard deviation (SD) 5.5], three-quarters (n = 103, 75.7%) had received an HIV test. Of these, one-quarter (n = 26, 25.2%) were HIV positive. In multivariable analyses, HIV testing was associated with: perceived HIV risk [adjusted odds ratio (AOR) 2.42, confidence interval (CI) 1.36-4.28], depression (AOR 1.34, CI 1.01-1.77), forced sex (AOR 3.83, CI 1.42-10.35), physical abuse (AOR 4.11, CI 1.44-11.72), perceived transgender stigma (AOR 1.23, 1.06-1.42), having a healthcare provider (AOR 5.89, CI 1.46-23.77), and lower HIV-related stigma (AOR 0.96, CI 0.92-0.99), incarceration (AOR 0.28, CI 0.10-0.78), and drug use (AOR 0.74, CI 0.58-0.95). HIV infection was associated with the following: homelessness (AOR 5.94, CI 1.27-27.74), perceived HIV risk (AOR 1.67, CI 1.02-2.72), depression (AOR 1.39, CI 1.06-1.82), STI history (AOR 56.79, CI 5.12-630.33), perceived (AOR 1.26, CI 1.06-1.51) and enacted (AOR 1.16, CI 1.04-1.29) transgender stigma, forced sex (AOR 4.14, CI 1.49-11.51), physical abuse (AOR 3.75, CI 1.39-10.12), and lower self-rated health (AOR 0.55, CI 0.30-0.98) and social support (AOR 0.79, CI 0.64-0.97). Transgender women in Jamaica experience high HIV infection rates and suboptimal HIV testing. Combination HIV prevention approaches should address transgender women's social and structural vulnerabilities.
1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Canada .|2 Women's College Research Institute , Women's College Hospital, Toronto, Canada .
Carmen H
CH
Logie
1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Canada .
Ashley
A
Lacombe-Duncan
1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Canada .
Ying
Y
Wang
3 Jamaica AIDS Support for Life , Kingston, Jamaica .
Nicolette
N
Jones
3 Jamaica AIDS Support for Life , Kingston, Jamaica .
Kandasi
K
Levermore
3 Jamaica AIDS Support for Life , Kingston, Jamaica .
Ava
A
Neil
3 Jamaica AIDS Support for Life , Kingston, Jamaica .
Tyrone
T
Ellis
4 Women's Empowerment for Change (WE-Change) , Kingston, Jamaica .
Nicolette
N
Bryan
3 Jamaica AIDS Support for Life , Kingston, Jamaica .
Sheldon
S
Harker
5 Institute for Gender and Development Studies, University of the West Indies , Mona Campus, Jamaica .
Annecka
A
Marshall
1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Canada .
Peter A
PA
Newman
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007563:Jamaica / Q000453:epidemiology; D016015:Logistic Models; D008403:Mass Screening / Q000706:statistics & numerical data*; D016017:Odds Ratio; D015995:Prevalence; D012725:Sexual Behavior; D057545:Social Stigma; D012944:Social Support; D019966:Substance-Related Disorders / Q000453:epidemiology; D063106:Transgender Persons / Q000706:statistics & numerical data*; D014189:Transsexualism / Q000523:psychology*; D055815:Young Adult; D008297:Male