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Impact of Minority Stress and Poor Mental Health on Sexual Risk Behaviors among Transgender Women Sex Workers in Shenyang, China

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Abstract

This study examined the associations between minority stressors, poor mental health, and sexual risk behaviors, and whether there were interactive effects of minority stress and mental health factors in their associations with sexual risk behaviors in a sample of Chinese transgender women sex workers (TGSW). A cross-sectional study was conducted in 204 TGSW in Shenyang, China (mean age 33.4 years and 18.1% self-reported as HIV positive). We found a high prevalence of condomless anal intercourse (CAI) with male clients (27.9%) and CAI with male regular partners (49.5%) in the past three months among TGSW. Multivariate logistic regression analysis showed that discrimination, victimization, and life dissatisfaction were significantly associated with higher odds of CAI with male clients (AOR range: 1.05–1.42, all p < 0.05). Likewise, CAI with male regular partners was more frequently reported by participants who experienced higher levels of victimization, rejection, and anxiety (AOR range: 1.37–2.88, all p < 0.05). No significant interaction effects of gender minority stress and mental health on sexual behaviors were observed. Interventions addressing the multiple psychosocial risks are warranted to prevent behavioral risks of TGSW.

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Acknowledgements

We would like to thank the participants for their cooperation in this study.

Funding

The Project was supported by internal funding of the Centre for Health Behaviours Research of the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong.

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Authors and Affiliations

  1. JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China

    Rui She, Phoenix Kit-han Mo & Joseph Tak-fai Lau

  2. Shenyang Consultation Centre of AIDS Aid and Health Service, Shenyang, China

    Tiecheng Ma & Yan Liu

Authors
  1. Rui She
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  2. Phoenix Kit-han Mo
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  3. Tiecheng Ma
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  4. Yan Liu
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  5. Joseph Tak-fai Lau
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RS, TM, and YL. The first draft of the manuscript was written by RS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Joseph Tak-fai Lau.

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She, R., Mo, P.Kh., Ma, T. et al. Impact of Minority Stress and Poor Mental Health on Sexual Risk Behaviors among Transgender Women Sex Workers in Shenyang, China. AIDS Behav 25, 1790–1799 (2021). https://doi.org/10.1007/s10461-020-03108-5

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  • DOI: https://doi.org/10.1007/s10461-020-03108-5

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