Archives of Sexual Behavior

, Volume 36, Issue 6, pp 768–777 | Cite as

Perceived Risks and Benefits of Sex Work among Transgender Women of Color in San Francisco

  • Lydia A. SausaEmail author
  • JoAnne Keatley
  • Don Operario
Original Paper


Prior research has shown that male-to-female (MTF) transgender women of color in the United States have a high rate of HIV infection and often engage in sex work for economic survival. With the exception of studies on HIV prevalence and behavioral risk, little research exists to elucidate the social context and determinants of sex work and related health risks among these women. Through a qualitative analysis of seven focus groups with 48 transgender women of color, we examined why and how participants became involved in sex work, documented risks associated with sex work, and explored what motivated participants to remain in sex work. Participants reported on how social networks and cultural norms, immigration issues, and experiences of racism, sexism, and transphobia influenced their decisions to enter and the risks encountered in sex work. Findings revealed that transgender women of color who engage in sex work have unique needs and experiences that must be addressed through structural and social network-based interventions to minimize their vulnerability to social and public health harms.


Sex work Transsexual Transgender HIV/AIDS 



This research study was funded by a grant from the National Institutes on Drug Abuse Grant R01 DA11589. The authors would like to thank the principal investigator, Tooru Nemoto, Ph.D., from the Center for AIDS Prevention Studies at the University of California, San Francisco, and everyone who assisted in the research study, including the participants, outreach workers, focus group facilitators, transcribers, and community collaborators and health professionals who provide services to transgender women of color. We also thank Jae Sevelius, Ph.D., and Julie Lifshay, Ph.D., M.P.H., for their editorial feedback and comments.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Lydia A. Sausa
    • 1
    • 3
    Email author
  • JoAnne Keatley
    • 1
  • Don Operario
    • 2
  1. 1.Department of Family and Community MedicineUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Department of Social Policy and Social WorkUniversity of OxfordOxfordUK
  3. 3.San FranciscoUSA

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