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Impact of Sexual Violence Across the Lifespan on HIV Risk Behaviors Among Transgender Women and Cisgender People Living With HIV.

ABSTRACT: BACKGROUND:To examine sexual violence across the lifespan among transgender and cisgender people living with HIV and its associations with recent risk behaviors. SETTING:Seven community-based sites serving priority populations disproportionately affected by HIV in the United States, including major metropolitan areas in the West and East Coast, as well as the suburban Mid-Atlantic and rural Southeastern regions. METHODS:From 2013 to 2016, baseline survey data were collected from participants (N = 583) of a multisite community-based HIV linkage to/retention in care study conducted at 7 sites across the United States. Adjusted mixed-effects logistic regression models with random effect for site-assessed associations of sexual violence and gender identity with risk outcomes including condomless sex, sex trade involvement, and substance use-related harms. RESULTS:One-third of participants reported a history of sexual violence; transgender [adjusted odds ratio (AOR) = 5.1, 95% confidence interval (CI): 2.6 to 10.1] and cisgender women (AOR = 3.8, 95% CI: 2.3 to 6.4) were more likely than cisgender men to experience sexual violence. Sexual violence was associated with experiencing drug-related harms (AOR = 2.6, 95% CI: 1.2 to 5.5). Transgender women were more likely than cisgender men to have sold sex (AOR = 9.3, 95% CI: 1.7 to 50.0). CONCLUSIONS:A history of sexual violence is common among transgender and cisgender women PLWH, and it increases risk for drug-related harms. Transgender women are also more likely to report selling sex.

SUBMITTER: Smith LR

PROVIDER: S-EPMC5810354 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Impact of Sexual Violence Across the Lifespan on HIV Risk Behaviors Among Transgender Women and Cisgender People Living With HIV.

Smith Laramie R LR Yore Jennifer J Triplett Daniel P DP Urada Lianne L Nemoto Tooru T Raj Anita A

Journal of acquired immune deficiency syndromes (1999) 20170801 4

<h4>Background</h4>To examine sexual violence across the lifespan among transgender and cisgender people living with HIV and its associations with recent risk behaviors.<h4>Setting</h4>Seven community-based sites serving priority populations disproportionately affected by HIV in the United States, including major metropolitan areas in the West and East Coast, as well as the suburban Mid-Atlantic and rural Southeastern regions.<h4>Methods</h4>From 2013 to 2016, baseline survey data were collected ...[more]

PMID: 28653970

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Project description:BACKGROUND:In the United States, approximately one-fifth of transgender women are living with HIV-nearly one-half of Black/African American (Black) transgender women are living with HIV. Limited data are available on HIV-related clinical indicators among transgender women. This is because of a lack of robust transgender data collection and research, especially within demographic subgroups. The objective of this study was to examine retention in care and viral suppression among transgender women accessing the Health Resources and Services Administration's (HRSA) Ryan White HIV/AIDS Program (RWHAP)-supported HIV care, compared with cisgender women and cisgender men. METHODS AND FINDINGS:We assessed the association between gender (cisgender or transgender) and (1) retention in care and (2) viral suppression using 2016 client-level RWHAP Services Report data. Multivariable modified Poisson regression models adjusting for confounding by age, race, health care coverage, housing, and poverty level, overall and stratified by race/ethnicity, were used to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). In 2016, the RWHAP served 6,534 transgender women (79.8% retained in care, 79.0% virally suppressed), 143,173 cisgender women (83.7% retained in care, 84.0% virally suppressed), and 382,591 cisgender men (81.0% retained in care, 85.9% virally suppressed). Black transgender women were less likely to be retained in care than Black cisgender women (aPR: 0.95, 95% CI: 0.92-0.97, p < 0.001). Black transgender women were also less likely to reach viral suppression than Black cisgender women (aPR: 0.55, 95%I CI: 0.41-0.73, p < 0.001) and Black cisgender men (aPR: 0.55, 95% CI: 0.42-0.73, p < 0.001). A limitation of the study is that RWHAP data are collected for administrative, not research, purposes, and clinical outcome measures, including retention and viral suppression, are only reported to the RWHAP for the approximately 60% of RWHAP clients engaged in RWHAP-supported outpatient medical care. CONCLUSIONS:In this study, we observed disparities in HIV clinical outcomes among Black transgender women. These results fill an important gap in national HIV data about transgender people with HIV. Reducing barriers to HIV medical care for transgender women is critical to decrease disparities among this population.

Project description:BackgroundBlack cisgender gay, bisexual, and other sexual minority men (SMM) and transgender women (TW) continue to be heavily affected by HIV. Further research is needed to better understand HIV prevention and care outcomes in this population. In particular, there is a need for research examining the impact of substance use and sleep health on HIV prevention and treatment outcomes among Black SMM and TW.ObjectiveThis paper outlines the study methods being used in the recently launched follow-up study to the Neighborhoods and Networks (N2) study, which we refer to as N2 Part 2 (N2P2). N2P2 aims to address this gap in the literature, build off the findings of the original N2 study, and identify socioenvironmental determinants of health, including whether neighborhood and network factors mediate and moderate these relationships.MethodsBuilding on the N2 cohort study in Chicago from 2018 to 2022, N2P2 used a prospective longitudinal cohort design and an observational-implementation hybrid approach. With sustained high levels of community engagement, we aim to recruit a new sample of 600 Black SMM and TW participants residing in the Chicago metropolitan statistical area. Participants are asked to participate in 3 study visits across an 18-month study period (1 visit every 9 months). Four different forms of data are collected per wave: (1) an in-person survey, (2) biological specimen collection, (3) a daily remote ecological momentary assessment for 14 days after each study visit, and (4) data from electronic health records. These forms of data collection continue to assess neighborhood and network factors and specifically explore substance use, sleep, immune function, obesity, and the implementation of potential interventions that address relevant constructs (eg, alcohol use and pre-exposure prophylaxis adherence).ResultsThe N2P2 study was funded in August 2021 by the National Institute of Drug Abuse (R01DA054553 and R21DA053156) and National Heart, Lung, and Blood Institute (R01HL160325). This study was launched in November 2022. Recruitment and enrollment for the first wave of data collection are currently ongoing.ConclusionsThe N2P2 study is applying innovative methods to comprehensively explore the impacts of substance use and sleep health on HIV-related outcomes among an HIV status-neutral cohort of Black SMM and TW in Chicago. This study is applying an observational-implementation hybrid design to help us achieve findings that support rapid translation, a critical priority among populations such as Black SMM and TW that experience long-standing inequities with regard to HIV and other health-related outcomes. N2P2 will directly build off the findings that have resulted from the original N2 study among Black SMM and TW in Chicago. These findings provide a better understanding of multilevel (eg, individual, network, and neighborhood) factors that contribute to HIV-related outcomes and viral suppression among Black SMM and TW.International registered report identifier (irrid)DERR1-10.2196/48548.

Project description:BackgroundTransgender people experience high rates of suicidality and self-harm. Past research has established a range of correlates of suicidality/self-harm among transgender people but little is known about whether these correlates are similar for transgender and cisgender people.AimsThe aim of this study was to test whether a range of potential demographic and psychosocial correlates of suicidality/self-harm hold for both transgender and cisgender people living in Aotearoa/New Zealand and Australia.MethodsAn online survey was completed by 700 adults living in Aotearoa/New Zealand (n = 328) or Australia (n = 372). Targeted advertising was used to recruit transgender respondents (n = 392) and cisgender respondents (n = 308). Participants completed questions about demographics, discrimination (the Everyday Discrimination Scale), distress (the Kessler-10 scale), social support (the Multi-Dimensional Scale of Perceived Social Support), resilience (the Brief Resilience Scale), suicidality (the Suicidal Ideation Attributes Scale and other questions about ideation/attempts), and self-harm (the Deliberate Self-Harm Inventory).ResultsLifetime suicidal ideation, lifetime suicide attempts, and lifetime self-harm were more common among transgender participants. Discrimination was associated with lifetime suicide attempts and lifetime self-harm, particularly for transgender participants. Distress was consistently associated with recent suicidality and self-harm for transgender participants. Younger cisgender participants were more likely to report lifetime self-harm. Recent suicidal ideation was associated with lower social support among transgender participants but with lower resilience among cisgender participants.DiscussionThese findings reaffirm and expand on past research on suicidality/self-harm among transgender or cisgender people and demonstrate the relevance of tackling discrimination and distress experienced by transgender people. In addition, the findings highlight the importance of meeting additional social support needs among transgender people to help prevent suicide and self-harm.

Project description:BackgroundThe term "transgender" refers to an individual whose gender identity is different from their sex assigned at birth, whereas the term "cisgender" refers to an individual whose gender identity is the same as their sex assigned at birth. In Thailand, studies on health outcomes and quality of life of Thai transgender youths have not included assessments from nationally-representative samples. The objective of this study is to assess the extent that behavioral health outcomes and exposure to violence varied by gender among respondents of the National School Survey on Alcohol Consumption, Substance Use and Other Health-Risk Behaviors.MethodsWe used data from a nationally-representative self-administered survey of secondary school students in years 7, 9 and 11 and classified participants as cisgender boys, cisgender girls, transgender boys, and transgender girls. Participants also answered questions on depressive experience, suicidality, sexual behaviors, alcohol and tobacco use, drug use, and past-year experience of violence. We analyzed data using descriptive statistics and modified multivariate Poisson regression with adjustment for sampling weights to calculate adjusted prevalence ratios (APR) with 95% confidence intervals.ResultsA total of 31,898 respondents (82.8% of those who returned complete and valid questionnaires) answered questions on sex and gender identity and were included in the analyses (n = 31,898 respondents), approximately 2.5% of whom identified as transgender. Transgender boys had a higher prevalence suicidal ideation than cisgender boys (APR = 2.97; 95% CI = 1.89, 4.67) and cisgender girls (APR = 2.29; 95% CI = 1.55, 3.40). Transgender girls were less likely than cisgender boys and girls to be ever drinkers, while transgender boys were more likely than cisgender boys and girls to be ever drinkers. Transgender girls had higher past-year exposure to sexual violence than cisgender boys (APR = 2.74; 95% CI = 1.52, 4.95) and cisgender girls (APR = 4.93; 95% CI = 2.52, 9.67).ConclusionWe found disparities in behavioral health and experience of violence between transgender and cisgender adolescents in Thailand. The findings highlighted the need for program managers and policy makers to consider expanding local efforts to address health gaps in the LGBTQ community to also include school-going youth population.

Dataset Information

Impact of Sexual Violence Across the Lifespan on HIV Risk Behaviors Among Transgender Women and Cisgender People Living With HIV.

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Impact of Sexual Violence Across the Lifespan on HIV Risk Behaviors Among Transgender Women and Cisgender People Living With HIV.

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