title: Contextual, experiential, and behavioral risk factors associated with HIV status: a descriptive analysis of transgender women residing in Atlanta, Georgia.
abstract: This study assessed the prevalence of self-reported HIV infection among a community sample of transgender women and identified associated contextual, experiential, and behavioral factors. Ninety-two transgender women completed a self-administered interview. Recruitment occurred through an LGBT service organization, a transgender support group, transgender advocates, and informal communications. Eighty-two percent were African American/Black. Of 83 who knew their status, 60% reported being HIV infected. High rates of childhood sexual abuse (52%), rape (53%), intimate partner violence (56%), and incarceration (57%) were reported. Many did not have health insurance (53%), were not employed full-time nor in school (63%) and had been recently homeless (49%). HIV-infected transgender women as compared to HIV-uninfected transgender women were more likely to be African American/Black ( P = 0.04), and older than 34 years ( P = 0.01), unemployed/not in school ( P < 0.001). HIV-infected transgender women also experienced less trans-related discrimination ( P = 0.03), perceived less negative psychosocial impact due to trans status ( P = 0.04) and had greater happiness with their physical appearance ( P = 0.01). HIV-infected transgender women may experience relatively less trans-related stress compared to their HIV-uninfected counterparts. High rates of HIV, trauma, and social marginalization raise concerns for this population and warrant the development of structural and policy-informed interventions.
authors.affiliation: 1 Department of Health Promotion & Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA.
authors.forename: Laura F
authors.initials: LF
authors.lastname: Salazar
authors.affiliation: 2 Department of Health Promotion, College of Public Health, University of Kentucky, Lexington, KY, USA.|3 Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Crosby
authors.affiliation: 1 Department of Health Promotion & Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA.
authors.forename: Jamal
authors.initials: J
authors.lastname: Jones
authors.affiliation: 1 Department of Health Promotion & Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA.
authors.forename: Krishna
authors.initials: K
authors.lastname: Kota
authors.affiliation: 4 Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, Chicago, IL, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Hill
authors.affiliation: 5 Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Masyn
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005845:Georgia / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology / Q000635:transmission; D006801:Humans; D000066511:Intimate Partner Violence / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D011902:Rape; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners; D063106:Transgender Persons / Q000523:psychology* / Q000706:statistics & numerical data; D014189:Transsexualism / Q000523:psychology*
keywords: AIDS; HIV; North America; high-risk behavior; sexual behavior; transgender women