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AIDS and Behavior

, 10:217 | Cite as

The Impact of Exposure to Transphobia on HIV Risk Behavior in a Sample of Transgendered Women of Color in San Francisco

  • Eiko Sugano
  • Tooru Nemoto
  • Don Operario
Original Article

This study examined the relationship between exposure to transphobia—societal discrimination and stigma of individuals who do not conform to traditional notions of gender—and risk for engaging in unprotected receptive anal intercourse (URAI) among 327 transgendered women of color. Overall, 24% of participants had engaged in URAI at least once in the past 30 days. Individuals who self-identified as pre-operative transsexual/transgendered women were significantly more likely than self-identified females to have engaged in URAI. Although exposure to transphobia was not independently related to URAI, an interaction between age and experiencing discrimination was observed. Among transgendered women 18–25 years old, those reporting higher levels of exposure to transphobia had a 3.2 times higher risk for engaging in URAI compared to those reporting lower levels. Findings from this study corroborate the importance of exposure to transphobia on HIV risk, particularly among transgendered young adults.

KEY WORDS:

Transgendered HIV risk unprotected sex transphobia discrimination. 

Notes

ACKNOWLEDGMENTS

The authors would like to thank everyone who assisted in the research study including the study participants, community collaborators, outreach workers, health educators, and health professionals who provide services to transgendered women. In addition, the authors would like to thank Tor Neilands for his statistical expertise. This research was funded by the National Institutes on Drug Abuse (Grant R01 DA11589) to Tooru Nemoto, Principal Investigator.

REFERENCES

  1. Blommers, P. J., and Forsyth, R. A. (1983). Elementary statistical methods in psychology and education (Second ed.), Maryland: University Press of America.Google Scholar
  2. Bockting, W. O., Robinson, B. E., and Rosser, B. R. (1998). Transgender HIV prevention: A qualitative needs assessment. AIDS Care, 10(4), 505–525.CrossRefPubMedGoogle Scholar
  3. Boles, J., and Elifson, K. W. (1994). The social organization of transvestite prostitution and AIDS. Social Sciencei Medicine, 39(1), 85–93.CrossRefGoogle Scholar
  4. Clements, K., Willy, W., Kitano, K., and Marx, R. (1999). HIV prevention and health service needs of the transgender community in San Francisco. International Journal of Transgenderism, 3(1+2).Google Scholar
  5. Clements-Nolle, K., Marx, R., Guzman, R., and Katz, M. (2001). HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: Implications for public health intervention. American Journal of Public Health, 91(6), 915–921.PubMedGoogle Scholar
  6. Dean, L., Meyer, I. H., Robinson, K., Sell, R. L., Sember, R., Silenzio, V. M. B., Bowen, D., Bradford, J., Rothblum, E., Scout, M., White, J., Dunn, P., Lawrence, A., Wolfe, D., and Xavier, J. (2000). Lesbian, gay, bisexual, and transgender health: Findings and concerns. Journal of the Gay and Lesbian Medical Association, 4(3), 102–151.CrossRefGoogle Scholar
  7. Diaz, R. M., Ayala, G., Bein, E., Henne, J., and Marin, B. V. (2001). The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: Findings from 3 US cities. American Journal of Public Health, 91(6), 927–932.PubMedGoogle Scholar
  8. Feinberg, L. (2001). Trans health crisis: For us it's life or death. American Journal of Public Health, 91(6), 897–900.PubMedGoogle Scholar
  9. Green, J. (1994). Investigation into discrimination against transgendered people. San Francisco: San Francisco Human Rights Commission.Google Scholar
  10. Israel, G. E., and Tarver, D. E. (1997). Transgender care : recommended guidelines, practical information, and personal accounts. Philadelphia: Temple University Press.Google Scholar
  11. Kegeles, S. M., Hays, R. B., and Coates, T. J. (1996). The Mpowerment Project: A community-level HIV prevention intervention for young gay men. American Journal of Public Health, 86(8 Pt 1), 1129–1136.PubMedGoogle Scholar
  12. Kegeles, S. M., Hays, R. B., Pollack, L. M., and Coates, T. J. (1999). Mobilizing young gay and bisexual men for HIV prevention: A two-community study. AIDS, 13(13), 1753–1762.CrossRefPubMedGoogle Scholar
  13. Kellogg, T. A., Clements-Nolle, K., Dilley, J., Katz, M. H., and McFarland, W. (2001). Incidence of human immunodeficiency virus among male-to-female transgendered persons in San Francisco. Journal of Acquired Immune Deficiency Syndrome, 28(4), 380–384.Google Scholar
  14. Kenagy, G. P. (2002). HIV among transgendered people. AIDS Care, 14(1), 127–134.CrossRefPubMedGoogle Scholar
  15. Kreiss, J. L., and Patterson, D. L. (1997). Psychosocial issues in primary care of lesbian, gay, bisexual, and transgender youth. Journal of Pediatric Health Care, 11(6), 266–274.CrossRefPubMedGoogle Scholar
  16. Lombardi, E. (2001a). Enhancing transgender health care. American Journal of Public Health, 91(6), 869–872.PubMedCrossRefGoogle Scholar
  17. Lombardi, E. L., and van Servellen, G. (2000). Building culturally sensitive substance use prevention and treatment programs for transgendered populations. Journal of Substance Abuse Treatment, 19(3), 291–296.CrossRefPubMedGoogle Scholar
  18. Lombardi, E. L., Wilchins, R. A., Priesing, D., and Malouf, D. (2001b). Gender violence: Transgender experiences with violence and discrimination. Journal of Homosexuality, 42(1), 89–101.CrossRefPubMedGoogle Scholar
  19. Luhtanen, R., and Crocker, J. (1992). A collective self-esteem scale: Self-evaluation of one's social identity. Personality and Social Psychology Bulletin, 18, 302–318.CrossRefGoogle Scholar
  20. Meyer III, W., Bockting, W. O., Cohen-Kettenis, P., Coleman, E., DiCeglie, D., Devor, H., Gooren, L., Hage, J. J., Kirk, S., Kuiper, B., Laub, D., Lawrence, A., Menard, Y., Patton, J., Schaefer, L., Webb, A., and Wheeler, C. C. (2001). The standards of care for gender identity disorders–Sixth Version. International Journal of Transgenderism, 5(1).Google Scholar
  21. Modan, B., Goldschmidt, R., Rubinstein, E., Vonsover, A., Zinn, M., Golan, R., Chetrit, A., and Gottlieb-Stematzky, T. (1992). Prevalence of HIV antibodies in transsexual and female prostitutes. American Journal of Public Health, 82(4), 590–592.PubMedGoogle Scholar
  22. Nemoto, T. (1988). Social support and norms toward mobilizing: Social support among Japanese American elderly. Unpublished PhD dissertation, New York University.Google Scholar
  23. Nemoto, T., Luke, D., Mamo, L., Ching, A., and Patria, J. (1999). HIV risk behaviours among male-to-female transgenders in comparison with homosexual or bisexual males and heterosexual females. AIDS Care, 11(3), 297–312.CrossRefPubMedGoogle Scholar
  24. Nemoto, T., Operario, D., and Keatley, J. (in press). Health and social services for male-to-female transgenders of color in San Francisco. International Journal of Transgenderism.Google Scholar
  25. Nemoto, T., Operario, D., Keatley, J., Han, L., and Soma, T. (2004a). HIV risk behaviour among male-to-female transgender persons of color in San Francisco. American Journal of Public Health, 94, 1193–1199.PubMedGoogle Scholar
  26. Nemoto, T., Operario, D., Sevelius, J., Keatley, J., and Nguyen, H. T. (2004c). Transphobia among transgenders of color. Poster session presented at the annual meeting of the American Public Health Association, Washington, D. C., November 2004.CrossRefPubMedGoogle Scholar
  27. Nemoto, T., Operario, D., Sevelius, J., Keatley, J., Hung, L., and Sugano, E. (2004c). Role of transphobia on psychological vulnerability among male-to-female transgenders. Unpublished manuscript.Google Scholar
  28. Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  29. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton: Princeton University Press.Google Scholar
  30. Schilder, A. J., Kennedy, C., Goldstone, I. L., Ogden, R. D., Hogg, R. S., and O'Shaughnessy, M. V. (2001). “Being dealt with as a whole person.” Care seeking and adherence: the benefits of culturally competent care. Social Science Medicine, 52(11), 1643–1659.CrossRefPubMedGoogle Scholar
  31. Stevens, P. E., and Morgan, S. (1999). Health of lesbian, gay, bisexual, and transgender youth. Journal of Child Family Nursing, 2(4), 237–249; quiz 250–231.Google Scholar
  32. Sykes, D. L. (1999). Transgendered people: An “invisible” population (Vol. 12, No. 1), California: Office of AIDS.Google Scholar
  33. Xavier, J. M., and Simmons, R. (2000). The Washington Transgender Needs Assessment Survey.Google Scholar

Copyright information

© Springer Sciene+Business Media Inc. 2005

Authors and Affiliations

  1. 1.Department of PediatricsDivision of Adolescent Medicine, University of CaliforniaSan FranciscoUSA
  2. 2.Center for AIDS Prevention StudiesUniversity of CaliforniaSan FranciscoUSA
  3. 3.Department of Social Policy and Social WorkUniversity of OxfordOxfordUnited KingdomUSA
  4. 4.Department of PediatricsDivision of Adolescent Medicine3333 California Street, Suite 245, San FranciscoCA 94118

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