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AIDS and Behavior

, Volume 19, Issue 8, pp 1446–1453 | Cite as

Gender Abuse and Incident HIV/STI Among Transgender Women in New York City: Buffering Effect of Involvement in a Transgender Community

  • Larry Nuttbrock
  • Walter Bockting
  • Andrew Rosenblum
  • Sel Hwahng
  • Mona Mason
  • Monica Macri
  • Jeffrey Becker
Original Paper

Abstract

In a 3 year prospective study of 230 transgender women from the New York City Area, we further examined associations of gender-related abuse with HIV sexual risk behavior and incident HIV/STI, focusing here and the extent to which these associations are buffered by involvement in a transgender community. Largely consistent with the prior study, gender abuse was longitudinally associated with unprotected receptive anal intercourse (URAI) with casual and commercial sex partners, and the presumed biological outcome of this behavioral risk, new cases of HIV/STI. Both of these associations, gender abuse with URAI and HIV/STI, were significantly buffered by transgender community involvement (interaction effects). However, independent of these interaction effects, transgender community involvement was also positively associated with URAI and HIV/STI (direct effects). HIV prevention in this population should emphasize the benefits of interactions with transgender peers while also emphasizing the importance of resisting normative permission for HIV risk behavior from these same peers.

Keywords

Transgender Gender abuse HIV/STI Transgender community 

Notes

Acknowledgments

Supported by a Grant from the National Institute of Drug Abuse (NIDA) (1 R01 DA018080) (Larry Nuttbrock, Principal Investigator) and by a NIDA administrative research supplement to promote diversity in health related research (Sel Hwahng, Ph.D., Investigator). We thank the participants of this study for sharing their “life stories.”

References

  1. 1.
    Clements-Nolle K, Marx R, Guzman R, Katz M. HIV prevention, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention. Am J Pub Health. 2001;91(6):915–21.CrossRefGoogle Scholar
  2. 2.
    Kellog TA, Clements-Nolle K, Kelley J. Incidence of human immunodeficiency virus among male-to-female transgendered persons in San Francisco. J Acquir Immune Defic Syndr. 2001;28(4):380–4.CrossRefGoogle Scholar
  3. 3.
    Herbst JH, Jacobs ED, Finlayson TJ, et al. Estimating HIV prevalence and risk behaviors in transgender persons in the United States: a systematic review. AIDS Behavior. 2008;12(6):1–17.PubMedCrossRefGoogle Scholar
  4. 4.
    Nuttbrock LA, Hwahng S, Bockting W, et al. Lifetime risk factors for HIV/STI Infections among male to female transgender persons. J Acquir Immune Defic Syndr. 2009;52(3):417–21.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Elifson KW, Boles J, Posey E. Male transvestite prostitutes and HIV risk. Am J Pub Health. 1993;83:260–2.CrossRefGoogle Scholar
  6. 6.
    Gattari P, Spizzochino C, Valenzi C, et al. Behavioral patterns and HIV infection among drug using transvestites practicing prostitution in Rome. AIDS. 1992;4(1):83–7.CrossRefGoogle Scholar
  7. 7.
    Inciardi JA, Surratt J, Felles RR, et al. Sex, drugs, and the culture of transvestimo in Rio de Janeiro. In: Bockting W, Kirk S, editors. Transgender and HIV: risks, prevention and care. New York: Haworth Press; 2001.Google Scholar
  8. 8.
    Operario D, Soma T, Underhill K. Sex work and HIV status among transgender women: systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2008;48(1):97–103.PubMedCrossRefGoogle Scholar
  9. 9.
    Simon PA, Reback CJ, Bem CC. HIV prevalence and incidence among male-to-female transsexuals receiving prevention services in Los Angeles County. AIDS. 2000;14(18):2953–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Baral SD, Poteat T, Stromdahl S, et al. World wide burden of HIV in transgender women: a systematic review and meta analysis. Lancet Infect Dis. 2013;13(3):216–22.CrossRefGoogle Scholar
  11. 11.
    Nemoto T, Operario D, Keatley J, et al. HIV risk behaviors among male-to-female transgender persons of color in San Francisco. Am J Public Health. 2004;94(7):1193–9.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Nemoto T, Luke D, Mamo L, et al. HIV risk behaviours among male-to-female transgenders in comparison with homosexual or bisexual males and heterosexual females. AIDS Care. 1999;11(3):297–312.PubMedCrossRefGoogle Scholar
  13. 13.
    Laumann EO, Gagnon JH, Michael RT, et al. The social organization of sexuality: sexual practices in the United States. Chicago: University of Chicago Press; 1994.Google Scholar
  14. 14.
    Nuttbrock L, Bockting W, Rosenblum A, et al. Gender abuse, depressive symptoms and HIV and sexually transmitted infections among male-to-female transgender persons: a three year prospective study. Am J Pub Health. 2013;2:300–7.CrossRefGoogle Scholar
  15. 15.
    Kippax S, Crawford J, Davis M, Roden P, Dowsett G. Sustaining safe sex: a longitudinal study of homosexual men. AIDS. 1993;7:257–63.PubMedCrossRefGoogle Scholar
  16. 16.
    Weitz R. Life with AIDS. New Brunswick: Rutgers University Press; 1991.Google Scholar
  17. 17.
    Herek GM, Glant EK. Identity and community among gay and bisexual men in the era of AIDS: preliminary findings from the Sacramento men’s health study. In: Herek GM, Greene B, editors. AIDS, identity, and community: the HIV epidemic among lesbians and gay men. Thousand Oaks: Sage; 1995. p. 55–84.CrossRefGoogle Scholar
  18. 18.
    Fergas S, Lewis MA, Darbes LA, Butterfield RM. HIV risk and protection among gay male couples: the role of gay community integration. Health Educ Behav. 2005;32(2):151–71.CrossRefGoogle Scholar
  19. 19.
    Fergas S, Lewis MA, Darbes LA, Kral AH. Social support moderates the relationship between gay community integration and sexual risk behavior among gay males couples. Health Educ Behav. 2009;36(5):846–59.CrossRefGoogle Scholar
  20. 20.
    Ramirez-Valles J, Kuhns LM, Campbell RJ, Diaz RM. Social integration and health: community involvement, stigmatized identities, and sexual risks in Latino sexual minorities”. J Health Soc Behav. 2010;51(1):30–47.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Meyer I. Prejudice, social stress, and mental health in lesbian, gay and bisexual populations: conceptual and research evidence. Psychol Bull. 2003;129:674–97.PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Hatzenbeuhler ML. How does sexual minority stigma “get under the skin”? Psychol Bull. 2009;135:707–30.CrossRefGoogle Scholar
  23. 23.
    Thoits PA. Mechanisms linking social ties and support to physical and mental health. J Health Soc Behav. 2011;52(2):145–61.PubMedCrossRefGoogle Scholar
  24. 24.
    Corcoran K, Crasius J, Mussweiler T. Social comparison: motives, standards, and mechanisms. In: Chadee D, editor. Theories in social psychology. Oxford, England: Wiley-Blackwell; 2011.Google Scholar
  25. 25.
    Carrillo J, Corning AF, Dennehy TC, Crosby FJ. Relative deprivation: understanding the dynamics of discontent. In: Chadee D, editor. Theories in social psychology. Oxford, England: Wiley-Blackwell; 2011.Google Scholar
  26. 26.
    Rosario M, Schrimshaw EW, Hunter J. Predictors of substance use over time among gay, lesbian, and bisexual youth: an examination of three hypotheses. Addict Behav. 2004;29(8):1623–31.PubMedCrossRefGoogle Scholar
  27. 27.
    Baiocco R, D’Allesso M, Laghi F. Binge drinking among gay, and lesbian youths: the role of internalized sexual stigma, self-disclosure, and individual’s sense of connectedness to the gay community. Addict Behav. 2010;35:896–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Hamilton CJ, Mahal JR. Minority stress, masculinity, and social norms predicing ay men’s health risk behaviors. J Counsel Psychol. 2009;56:132–44.CrossRefGoogle Scholar
  29. 29.
    McMillan DW, Chavis DM. Sense of community: a definition and theory. Community Psychol. 1986;14:6–23.CrossRefGoogle Scholar
  30. 30.
    McKenna KYA, Bargh JA. Coming out in the age of the internet: identity “demarginalization” through virtual group participation. J Pers Soc Psychol. 1998;75:81–694.CrossRefGoogle Scholar
  31. 31.
    Hwahng S, Nuttbrock L. Sex workers, fem queens, and cross-dressers: differential marginalizations and HIV vulnerabilities among three male-to-female transgender communities in New York City. Sex Res Social Policy. 2007;4:36–59.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Lazarus RS, Foldman S. Stress, appraisal, and coping. New York: Springer; 1984.Google Scholar
  33. 33.
    Sue DW. Microaggressions in everyday life: gender and sexual orientation. Hoboken: John Wiley; 2010.Google Scholar
  34. 34.
    Pinkerton SD, Layde PM, for the NIMH multisite HIV prevention trial group. STIs as proxies for HIV infection. Sex Trans Dis. 2002;29(5):298–307.CrossRefGoogle Scholar
  35. 35.
    Hardin JR, Hilbe JR. Generalized estimating equations. 2nd ed. New York: CRC Press; 2012.Google Scholar
  36. 36.
    StataCorp. Stata Statistical Software: Release 9. College Station: StataCorp LP.Google Scholar
  37. 37.
    Cleves M, Gutienez R, Gould W, Marchenko Y. An introduction to survival analysis using Stata. 2nd ed. College Station: Stata Corp LP; 2008.Google Scholar
  38. 38.
    Jaccard J, Turrisi R. Interaction effects in multiple regression (2nd ed.) Sage University Paper Series in Quantitative Applications in the Social Sciences, 07-072. Thousand Oaks: Sage; 2003.Google Scholar
  39. 39.
    Verdjo-Garcia A. Negative emotion impulsivity predicts substance dependence problems. Drug Alcohol Depend. 2007;91:213–8.CrossRefGoogle Scholar
  40. 40.
    Gagnon JH, Simon W. Sexual Deviance. New York: Harper and Row; 1967.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Larry Nuttbrock
    • 1
    • 2
  • Walter Bockting
    • 3
  • Andrew Rosenblum
    • 1
  • Sel Hwahng
    • 1
  • Mona Mason
    • 1
  • Monica Macri
    • 1
  • Jeffrey Becker
    • 1
  1. 1.Institute of Treatment and Services Research at the National Development and Research Institutes (NDRI)New YorkUSA
  2. 2.ElmhurstUSA
  3. 3.LGBT Health Initiative, Division of Gender, Sexuality and HealthNew York State Psychiatric Institute/Columbia University Medical CenterNew YorkUSA

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