title: HIV-Related Sexual Risk Among Transgender Men Who Are Gay, Bisexual, or Have Sex With Men.
abstract: BACKGROUND
  This study is among the first to examine factors associated with HIV-related sexual risk among transgender men and other transmasculine persons who are gay, bisexual, or have sex with men (T-GBMSM).
  
  
  METHODS
  In 2009-2010, 433 transgender people in Ontario, Canada, participated in a multimode respondent-driven sampling survey, including 158 T-GBMSM. Analyses were weighted using respondent-driven sampling II methods to adjust for differential recruitment probabilities; confidence intervals (CI) were adjusted for clustering by shared recruiter. Prevalence ratios (PR) for associations with past-year high sexual risk (condomless intercourse outside a seroconcordant monogamous relationship) were estimated using average marginal predictions from logistic regression.
  
  
  RESULTS
  Of T-GBMSM (mean age = 29.8; 52% living full time in felt gender; 25% Aboriginal or persons of color; 0% self-reported HIV positive), 10% had high sexual risk activity in the past year. Among the 34% with a past-year cisgender (non-transgender) male sex partner, 29% had high sexual risk. In multivariable analyses, older age, childhood sexual abuse (adjusted PR, APR = 14.03, 95% CI: 2.32 to 84.70), living full time in one's felt gender (APR = 5.20, 95% CI: 1.11 to 24.33), and being primarily or exclusively attracted to men (APR = 5.54, 95% CI: 2.27 to 13.54) were each associated with sexual risk. Of psychosocial factors examined, past-year stimulant use (APR = 4.02, 95% CI: 1.31 to 12.30) and moderate depressive symptoms (APR = 5.77, 95% CI: 1.14 to 29.25) were associated with higher sexual risk.
  
  
  CONCLUSIONS
  T-GBMSM seem to share some HIV acquisition risk factors with their cisgender counterparts. HIV prevention interventions targeting T-GBMSM who are predominantly attracted to men and interventions addressing sequelae of childhood sexual abuse may be warranted.
authors: *Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; and †Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada.
authors: Ayden I
authors: AI
authors: Scheim
authors: Greta R
authors: GR
authors: Bauer
authors: Robb
authors: R
authors: Travers
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000706:statistics & numerical data; D002648:Child; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D006716:Homosexuality / Q000706:statistics & numerical data; D006801:Humans; D000066511:Intimate Partner Violence / Q000706:statistics & numerical data; D008297:Male; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000523:psychology; D057545:Social Stigma; D019966:Substance-Related Disorders / Q000453:epidemiology; D063106:Transgender Persons / Q000523:psychology / Q000706:statistics & numerical data*; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult