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Tordoff DM, Minalga B, Perry NL, Gross B, Khosropour CM, Glick SN, Barbee LA, Duerr A. Heterogeneity in HIV/Sexually Transmitted Infection Prevalence and Prevention Among the Partners of Transgender and Nonbinary People. Sex Transm Dis 2023; 50:280-287. [PMID: 36881439 PMCID: PMC11243647 DOI: 10.1097/olq.0000000000001796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
BACKGROUND Transgender and nonbinary (TNB) people are diverse in their sexual orientation and partnerships. We describe the epidemiology of HIV/sexually transmitted infection (STI) prevalence and prevention utilization among the partners of TNB people in Washington State. METHODS We pooled data from five 2017 to 2021 cross-sectional HIV surveillance data sources to generate a large sample of TNB people and cisgender people who had a TNB partner in the past year. We described characteristics of recent partners of trans women, trans men, and nonbinary people and used Poisson regression to assess if having a TNB partner was associated with self-reported HIV/STIs prevalence, testing, and preexposure prophylaxis (PrEP) use. RESULTS Our analysis included 360 trans women, 316 trans men, 963 nonbinary people, 2896 cis women, and 7540 cis men. Overall, 9% of sexual minority cis men, 13% of sexual minority cis women, and 36% of TNB participants reported having any TNB partners. There was significant heterogeneity in HIV/STI prevalence, testing, and PrEP use among the partners of TNB people by study participant gender and the gender of their sex partners. In regression models, having a TNB partner was associated with a higher likelihood of HIV/STI testing and PrEP use but was not associated with higher HIV prevalence. CONCLUSIONS We observed significant heterogeneity in HIV/STI prevalence and preventative behaviors among the partners of TNB people. Given that TNB people are diverse in their sexual partnerships, there is a need to better understand individual-, dyad-, and structural-level factors that facilitate HIV/STI prevention across these diverse partnerships.
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Affiliation(s)
- Diana M Tordoff
- From the Department of Epidemiology, University of Washington
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2
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Brewer R, Ramani SL, Khanna A, Fujimoto K, Schneider JA, Hotton A, Wilton L, Escobedo T, Harawa NT. A Systematic Review up to 2018 of HIV and Associated Factors Among Criminal Justice-Involved (CJI) Black Sexual and Gender Minority Populations in the United States (US). J Racial Ethn Health Disparities 2022; 9:1357-1402. [PMID: 34296420 PMCID: PMC8297427 DOI: 10.1007/s40615-021-01076-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022]
Abstract
Black men who have sex with men (BMSM) and Black transgender women (BTW) are impacted by dual epidemics of HIV and incarceration. We advanced understanding of the relationship between criminal justice involvement, HIV, and other key HIV-related characteristics among these key populations in the US. We conducted a systematic review up to 2018 and 47 articles met the inclusion criteria of scientific publications involving quantitative findings of US-based HIV-related studies focused on criminal justice-involved (CJI) BMSM and BTW. Overall, there was a dearth of studies focused specifically on BTW. Criminal justice involvement was relatively high among BMSM and BTW and more pronounced among BTW. The current evidence favors no association between incarceration and HIV acquisition among BMSM with limited information about BTW. Criminal justice involvement was associated with a greater likelihood of STIs among BMSM with mixed results for sexual risk behaviors. Criminal justice settings served as an important venue for HIV testing/diagnosis for both BMSM and BTW. However, these settings were not conducive for subsequent stages of the HIV care continuum. Studies pointed to an independent association between criminal justice involvement, substance use, housing instability, and greater odds of incarceration among BMSM who were unemployed and had limited education. Future incarceration was associated with high levels of perceived racism among BMSM. Among young BMSM, high network criminal justice prevalence was also associated with sexual risk behaviors, poorer mental health outcomes, drug use, and housing instability. CJI BMSM and BTW represent a critical subpopulation to end the HIV epidemic in the US.
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Affiliation(s)
- Russell Brewer
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA.
| | - Santhoshini L Ramani
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA
| | - Aditya Khanna
- Department of Behavioral and Social Science, Brown University, Providence, RI, USA
| | - Kayo Fujimoto
- Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA
| | - Anna Hotton
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA
| | - Leo Wilton
- State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Tania Escobedo
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, MC5065, Chicago, IL, 60637, USA
| | - Nina T Harawa
- David Geffen School of Medicine, General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA, USA
- College of Medicine, Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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Khan MR, Brewer R, Abrams J, Mazumdar M, Scheidell JD, Feelemyer J, Dyer TV, Turpin RE, Hucks-Ortiz C, Gaydos CA, Severe M, Irvine NM, Kaufman JS, Cleland CM, Mayer KH. Incarceration and Sexual Risk Behavior and Incident Sexually Transmitted Infection/HIV in HIV Prevention Trials Network 061: Differences by Study City and Among Black Sexual Minority Men Who Have Sex With Men, Black Sexual Minority Men Who Have Sex With Men and Women, and Black Transgender Women. Sex Transm Dis 2022; 49:284-296. [PMID: 35312668 PMCID: PMC9387752 DOI: 10.1097/olq.0000000000001594] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Black sexual minority men (BSMM) and Black transgender women face a disproportionate risk of incarceration and sexually transmitted infection (STI)/HIV, yet research on the longitudinal association between incarceration and STI/HIV risk in these groups is limited. METHODS We used data from the HIV Prevention Trials Network (HPTN) 061 study conducted among BSMM and Black transgender women in Atlanta, Boston, Los Angeles, New York City, San Francisco, and Washington, DC, restricting analyses to those who returned for the 6-month follow-up visit when recent incarceration was measured (n = 1169). Using inverse probability of treatment weighting, we measured associations between incarceration and next 6-month multiple partnerships; selling or buying sex; condomless anal intercourse; and incident chlamydia, gonorrhea, syphilis, and HIV. We explored differences by study city, and among BSMM who had sex with men only, BSMM who had sex with men and women, and Black transgender women. RESULTS Approximately 14% reported past 6-month incarceration. Incarceration was associated with next 6-month selling sex (adjusted risk ratio [ARR], 1.80; 95% confidence interval [CI], 1.12-2.87) in the overall sample and multiple partnerships among BSMM who had sex with men and women (ARR, 1.34; 95% CI, 1.10-1.63) and transgender women (ARR, 1.77; 95% CI, 1.22-2.57). There is evidence suggesting that incarceration may predict gonorrhea (ARR, 2.35; 95% CI, 0.95-5.77), with particularly strong associations observed in Los Angeles (ARR, 6.48; 95% CI, 1.48-28.38). CONCLUSIONS Incarceration may increase STI/HIV risk among BSMM and Black transgender women. Additional mixed-methods research is needed to validate associations and understand pathways.
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Affiliation(s)
- Maria Rabia Khan
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL
| | - Jasmyn Abrams
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Medha Mazumdar
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Joy D Scheidell
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Jonathan Feelemyer
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
| | - Rodman E Turpin
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
| | | | - Charlotte A Gaydos
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - MacRegga Severe
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Natalia M Irvine
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Charles M Cleland
- From the Department of Population Health, New York University School of Medicine, New York, University, New York, NY
| | - Kenneth H Mayer
- The Fenway Institute, and Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
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Skeen SJ, Starks TJ, Jimenez RH, Rendina HJ, Cain D. Heterosexual Cisgender Men Partnered with Transgender Women Exhibit Higher HIV/STI Sexual Risk than Their Gay, Bisexual, and Queer Counterparts: Findings from a U.S.-Based Convenience Sample Recruited Online. AIDS Behav 2021; 25:3279-3291. [PMID: 34050403 PMCID: PMC10062375 DOI: 10.1007/s10461-021-03314-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 01/15/2023]
Abstract
Cisgender men are frequently vectors for HIV transmission among transgender women. Despite this, the correlates of sexual risk among these men remain under-examined. The purpose of the present study was to explore potential differences in relationship characteristics, sexual risk-taking, and risk-reduction strategies among cisgender men partnered with transgender women. The study utilized secondary screening data provided by adult cis men who reported being in a primary relationship with a trans woman (N = 710). Gay men (18%) were comparatively older, and most likely to report both HIV seropositivity and committed pairings. Heterosexual men (14%) were more likely to report exchange sex, briefer relationships, extra-dyadic sex, lesser serostatus awareness or PrEP uptake. Queer men (7%) were youngest, and most likely to access PrEP. Heterosexual cis men with trans women partners may be subject to unique socio-cultural drivers of sexual risk, such as heteronormative pressures and relationship stigma.
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Affiliation(s)
- Simone J Skeen
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA.
- School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA.
| | - Tyrel J Starks
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science PhD Program, The Graduate Center, CUNY, New York, NY, USA
| | - Ruben H Jimenez
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science PhD Program, The Graduate Center, CUNY, New York, NY, USA
| | - Demetria Cain
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
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5
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Scheidell JD, Dyer TV, Hucks-Ortiz C, Abrams J, Mazumdar M, Cleland C, Irvine N, Turpin RE, Severe M, Mayer K, Khan M. Characterisation of social support following incarceration among black sexual minority men and transgender women in the HPTN 061 cohort study. BMJ Open 2021; 11:e053334. [PMID: 34588263 PMCID: PMC8483031 DOI: 10.1136/bmjopen-2021-053334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine longitudinal associations between recent incarceration and subsequent social support among black sexual minority men and transgender women, and whether associations differed between those who did and did not have support prior to incarceration. DESIGN A secondary analysis in 2020 of data from the HIV Prevention Trials Network 061, a cohort study of black sexual minority men and transgender women recruited in 2009-2010 and followed for 12 months. SETTING Six US cities (Atlanta, Boston, Los Angeles, New York City, San Francisco and Washington DC). PARTICIPANTS Individuals ≥18 years of age who identified as black, reported being male or assigned male at birth, reported ≥1 unprotected anal intercourse event with a male partner in the past 6 months, and reported on incarceration at the 6-month follow-up visit. EXPOSURE Having spent ≥1 night in jail/prison in the past 6 months reported at the 6-month follow-up visit. OUTCOME Social support measured using a six-item scale assessing frequency of emotional/informational, affectionate and tangible support (range 6-30); and dichotomous indicators of low support for each item (ie, receiving that form of support none/little of the time). RESULTS Among participants who returned for the 6-month visit (N=1169), 14% had experienced incarceration in the past 6 months. Mean support score was 20.9; 18.9 among those with recent incarceration versus 21.2 among those without. Recent incarceration predicted lower support (adjusted β -2.40, 95% CI -3.94 to -0.85). Those recently incarcerated had increased risk of lacking emotional/informational (eg, no one to talk to adjusted risk ratio (aRR) 1.55, 95% CI 1.13 to 2.13) and affectionate (aRR 1.51, 95% CI 1.11 to 2.04) but not tangible support. Effects appeared somewhat stronger among those who had support at baseline. CONCLUSIONS Incarceration may reduce support on re-entry among black sexual minority men and transgender women, populations unequally targeted for incarceration and at risk for low support.
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Affiliation(s)
- Joy D Scheidell
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Typhanye V Dyer
- School of Public Health, Epidemiology and Biostatistics, University of Maryland at College Park, College Park, Maryland, USA
| | | | - Jasmyn Abrams
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Medha Mazumdar
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Charles Cleland
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Natalia Irvine
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Rodman E Turpin
- School of Public Health, Epidemiology and Biostatistics, University of Maryland at College Park, College Park, Maryland, USA
| | - MacRegga Severe
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Kenneth Mayer
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Maria Khan
- Population Health, New York University School of Medicine, New York, New York, USA
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Turpin R, Dyer T, Watson L, Mayer K. Classes of Sexual Identity, Homophobia, and Sexual Risk among Black Sexual Minorities in HPTN 061. JOURNAL OF SEX RESEARCH 2021; 58:638-647. [PMID: 33630695 PMCID: PMC8154646 DOI: 10.1080/00224499.2021.1886228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Homophobia is associated with sexual risk among sexual minorities, including Black sexual minority men, though experienced homophobia may differ across sexual identities. We conducted latent class analysis of sexual identities and experienced homophobia associated with sexual risk, and tested mediators of this association. We used longitudinal data from the HIV Prevention Trials Network Study 061 (n = 1,553). We generated rate ratios between baseline latent classes of experienced homophobia and sexual identity and 12-month outcomes: Condomless receptive anal intercourse (CRAI), number of partners, and transactional sex. Mediators included 6-month internalized homophobia, depression, social support, and substance use. We selected the following 7-class model: "Bisexual, rare homophobia" (reference), "Mixed identities, mixed homophobia", "Bisexual, frequent homophobia", "Heterosexual/Same-gender loving, frequent homophobia", "Gay, frequent homophobia", " Gay/Same-gender loving, frequent homophobia," and "Gay, rare homophobia." All other classes had greater CRAI than the reference. For bisexual/mixed/heterosexual classes, approximately 20% of this association was positively mediated through our mediators (p < .05). The Heterosexual/Same-gender loving class had the largest proportion mediated through internalized homophobia. For gay-identifying classes, mediation was marginally significant (.05 < p < .10). Classes of sexual identity and experienced homophobia were associated with CRAI among Black sexual minority men, partially mediated through internalized homophobia, depression, social support, and substance use.
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Affiliation(s)
- Rodman Turpin
- Department of Epidemiology and Biostatistics, University of Maryland at College Park, School of Public Health, College Park, MD
| | - Typhanye Dyer
- Department of Epidemiology and Biostatistics, University of Maryland at College Park, School of Public Health, College Park, MD
| | - Lakeshia Watson
- Department of Epidemiology and Biostatistics, University of Maryland at College Park, School of Public Health, College Park, MD
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7
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Petterson LJ, Vasey PL. Samoan Men's Sexual Attraction and Viewing Time Response to Male-to-Feminine Transgender and Cisgender Adults. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:873-884. [PMID: 33492521 DOI: 10.1007/s10508-020-01905-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 06/12/2023]
Abstract
In many different cultures, some men express sexual interest in male-to-feminine (MtF) transgender individuals, but others do not. We examined whether, in Samoa, men who are sexually interested in fa'afafine (Samoan MtF transgender individuals) (MSF; N = 40) differed from men who were exclusively sexually interested in women (MSW; N = 41) in terms of their self-reported sexual attraction and viewing times responses to images of MtF transgender individuals who were feminine (e.g., had feminine hairstyles, makeup) but had not undergone gender-affirming surgeries (e.g., breast augmentation), cisgender women, and cisgender men. MSF reported that images of MtF transgender individuals were sexually attractive, although somewhat less attractive than images of cisgender women. In contrast, MSW reported that images of cisgender women were sexually attractive, but images of MtF transgender individuals were not. The groups did not differ in their sexual attraction ratings of men, which were uniformly low. MSF viewed MtF transgender individuals and cisgender women for a similar length of time and viewed both longer than cisgender men. In contrast, MSW viewed cisgender women longer than MtF transgender individuals and they viewed MtF transgender individuals longer than cisgender men. The present study indicates that responses to MtF transgender individuals vary among Samoan men who share a sexual preference for women.
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Affiliation(s)
- Lanna J Petterson
- Laboratory of Comparative Sexuality, Department of Psychology, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada.
| | - Paul L Vasey
- Laboratory of Comparative Sexuality, Department of Psychology, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
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8
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Syndemic latent transition analysis in the HPTN 061 cohort: Prospective interactions between trauma, mental health, social support, and substance use. Drug Alcohol Depend 2020; 214:108106. [PMID: 32652374 PMCID: PMC7423755 DOI: 10.1016/j.drugalcdep.2020.108106] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/27/2020] [Accepted: 05/23/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Substance use among Black sexual minority men (BSMM) is a significant public health focus of prevention interventions due to its association with sexual risk behaviors and transmission of HIV. Traumatic experiences and mental health challenges may interact to create a syndemic associated with substance use in this population; this may be moderated by social support however. METHODS Using a multicenter prospective cohort of 1068 BSMM, we conducted a longitudinal syndemic latent transition analysis testing whether baseline and 6-month race and sexuality-targeted violence, intimate partner violence, other traumatic experiences, depression, and internalized homophobia was associated with 12-month substance use. We also tested if social support modified this and was associated with transitions between statuses. RESULTS Our analysis identified four statuses: A "low-risk" status characterized by the lowest proportions of syndemic factors, and 3 "high-risk" statuses, characterized by higher proportions of syndemic factors. All three high-risk statuses were associated with higher substance use than the low-risk status, with the greatest association observed with "high-risk status C" (aRR = 4.54, 95 % CI 1.98, 10.40). Social support attenuated this association (Interaction aRR = 0.21, 95 % CI 0.05, 0.85) and was associated with lower transition rates from low to high-risk status 6 months later (Transition ratio = 0.45, 95 % CI 0.29, 0.69). CONCLUSIONS Our findings identified a syndemic of trauma, depression, and homophobia among BSMM associated with substance use, but attenuated by social support. Future research into the role of social support and resiliency in substance use prevention and recovery is recommended.
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9
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Understanding HIV risk and vulnerability among cisgender men with transgender partners. Lancet HIV 2020; 7:e201-e208. [PMID: 32032535 DOI: 10.1016/s2352-3018(19)30346-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/16/2019] [Accepted: 09/20/2019] [Indexed: 12/18/2022]
Abstract
In the HIV pandemic, cisgender (ie, non-transgender) men with transgender partners are an underserved population. Complexities of sexuality and gender affect HIV vulnerability for this group, including not identifying with conventional sexual orientation categories (eg, bisexual, heterosexual, or gay) and having attractions based on gender role or expression rather than genital anatomy. Only one HIV prevention interventional study in this population was identified, and one study that assessed the perceived acceptability of an intervention. We found no data for interventions using pre-exposure prophylaxis, interventions for cisgender men with transgender men partners, or cisgender men with casual or transactional sexual partnerships with transgender people. Cisgender men with transgender partners are not easily categorised using traditional HIV risk categories. Additional research is needed to understand stigma and other structural drivers of HIV vulnerability, sexual networks and practices, substance use patterns, and biomedical prevention interest and uptake for this group. Studies that use an intersectional lens and syndemic framework could offer key insights.
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10
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Petterson LJ, Dixson BJ, Little AC, Vasey PL. Heterogeneity in the Sexual Orientations of Men Who Have Sex with Fa'afafine in Samoa. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:517-529. [PMID: 32016813 DOI: 10.1007/s10508-020-01646-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 06/10/2023]
Abstract
In Samoa, feminine natal males who possess male-typical genitalia are known locally as fa'afafine. Some Samoan men express sexual interest in fa'afafine, whereas others do not. To assess the sexual orientation of men who are sexually interested in fa'afafine, we collected sexual attraction ratings and viewing times of Samoan men's and women's faces. Study 1 (N = 130) focused on men who were insertive or versatile during anal sex with fa'afafine partners. These men were compared to each other, as well as to males (i.e., men and fa'afafine) who were exclusively sexually interested in either women or men. Study 2 (N = 180) compared men who had sex with fa'afafine and women; men who had sex with fa'afafine, women, and men; and men who had sex with fa'afafine and men. These men were compared to each other, as well as to males who were exclusively sexually interested in either women or men. These studies suggest that men who have sex with fa'afafine are a heterogeneous group. A small portion of the men who are sexually interested in fa'afafine shows a relatively bisexual pattern of sexual attraction ratings and viewing times, namely men who have sex with fa'afafine, men, and women. In contrast, a larger number of men who were sexually interested in fa'afafine responded in a manner similar to men who were exclusively sexually interested in either women or men. The present research suggests that additional insights into male sexual orientation can be garnered by focusing on how sexuality is expressed in non-Western cultural contexts.
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Affiliation(s)
- Lanna J Petterson
- Laboratory of Comparative Sexuality, Department of Psychology, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada.
| | - Barnaby J Dixson
- Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, Australia
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | | | - Paul L Vasey
- Laboratory of Comparative Sexuality, Department of Psychology, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
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Hassan A, Wertheim JO, Blumenthal JS, Ellorin E, Dube MP, Corado K, Moore DJ, Morris SR. Characteristics of a cohort of high-risk men who have sex with men on pre-exposure prophylaxis reporting transgender sexual partners. Medicine (Baltimore) 2019; 98:e18232. [PMID: 31852085 PMCID: PMC6922495 DOI: 10.1097/md.0000000000018232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Transgender people continue to be at high-risk for HIV acquisition, but little is known about the characteristics of their sexual partners. To address this gap, we examined sociodemographic and sexual characteristics of cisgender men who have sex with men (MSM) on pre-exposure prophylaxis (PrEP) reporting transgender sexual partners.A cohort of 392 MSM in southern California in a randomized clinical trial for PrEP adherence were followed from 2013 to 2016. Multivariable generalized estimating equation and logistic models identified characteristics of MSM reporting transgender sexual partners and PrEP adherence.Only 14 (4%) MSM reported having transgender sexual partners. MSM were more likely to report transgender partners if they were African American, had incident chlamydia, reported injection drug-using sexual partners, or received items for sex. Most associations remained significant in the multivariable model: African American (adjusted odds ratio [AOR] 11.20, P = .01), incident chlamydia (AOR 3.71, P = .04), and receiving items for sex (AOR 5.29, P = .04). There were no significant differences in PrEP adherence between MSM reporting transgender partners and their counterpart.MSM who report transgender sexual partners share characteristics associated with individuals with high HIV prevalence. Identifying this group distinct from larger cohorts of MSM could offer new HIV prevention opportunities for this group of MSM and the transgender community.
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Affiliation(s)
- Adiba Hassan
- Department of Medicine, University of California, San Diego
| | | | | | - Eric Ellorin
- Department of Medicine, University of California, San Diego
| | - Michael P. Dube
- Department of Medicine, University of Southern California, Los Angeles
| | - Katya Corado
- Division of HIV Medicine, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
| | - David J. Moore
- Department of Psychiatry, University of California, San Diego, CA, USA
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