AIDS and Behavior

, Volume 15, Issue 3, pp 674–682 | Cite as

Unprotected Sexual Behavior and HIV Risk in the Context of Primary Partnerships for Transgender Women

  • Don Operario
  • Tooru Nemoto
  • Mariko Iwamoto
  • Toni Moore
Original Paper

Abstract

Previous research has reported that transgender women are likely to be exposed to HIV through unprotected sex with a male primary partner. We examined prevalence and correlates of unprotected sex with a primary male partner in a sample of n = 174 transgender women. Participants completed surveys on demographic characteristics, relationship dynamics with their male primary partner, sexual behavior, substance use, and psychosocial factors. Overall, 41% reported HIV positive status, 13% had another sexually transmitted infection during the past year, and 34% had unprotected sex with a male primary partner during the past 3 months. Factors associated with unprotected sex with a primary partner included living with the partner, drug use, alcohol use, education level, low self-efficacy to use condoms, and perceived discrimination. Notably, 35% of transgender women in HIV-discordant primary partnerships had unprotected sex with their male primary partner during the past 3 months, and 18% of transgender women in HIV-positive concordant primary partnerships had unprotected sex with an outside partner during the past 3 months. HIV prevention interventions for transgender women must address risk behavior in the context of primary partnerships as well as sex with concurrent partners outside the relationship. Couples-focused interventions involving transgender women and their male primary partners can be particularly promising.

Keywords

Transgender women HIV Sexual risk behavior Primary relationships 

Notes

Acknowledgments

This research was supported by NIH/NIDA R01-DA018621. We express our gratitude to members of our Community Advisory Board, and to Drs Colleen Hoff and Lynae Darbes for consultation on this research.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Don Operario
    • 1
  • Tooru Nemoto
    • 2
  • Mariko Iwamoto
    • 2
  • Toni Moore
    • 2
  1. 1.Department of Community HealthBrown UniversityProvidenceUSA
  2. 2.Public Health InstituteOaklandUSA

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