Advertisement

Archives of Sexual Behavior

, Volume 45, Issue 3, pp 597–605 | Cite as

Use of the Internet to Meet Sexual Partners, Sexual Risk Behavior, and Mental Health in Transgender Adults

  • Eric G. BenotschEmail author
  • Rick S. Zimmerman
  • Laurie Cathers
  • Ted Heck
  • Shawn McNulty
  • Juan Pierce
  • Paul B. Perrin
  • Daniel J. Snipes
Original Paper

Abstract

The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.

Keywords

Transgender Internet Sexual behavior HIV Commercial sex work 

References

  1. Albright, J. M. (2008). Sex in America online: An exploration of sex, marital status, and sexual identity in Internet sex seeking and its impacts. Journal of Sex Research, 45, 175–186.CrossRefPubMedGoogle Scholar
  2. Allison, S., Bauermeister, J. A., Bull, S., Lightfoot, M., Mustanski, B., Shegog, R., et al. (2012). The intersection of youth, technology, and new media with sexual health: Moving the research agenda forward. Journal of Adolescent Health, 51, 207–212.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Bauermeister, J. A., Johns, M. M., Sandfort, T. G. M., Eisenberg, A., Grossman, A. H., & D’Augelli, A. R. (2010). Relationship trajectories and psychological well-being among sexual minority youth. Journal of Youth and Adolescence, 39, 1148–1163.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Benotsch, E. G., Kalichman, S., & Cage, M. (2002). Men who have met sex partners via the Internet: Prevalence, predictors, and implications for HIV prevention. Archives of Sexual Behavior, 31, 177–183.CrossRefPubMedGoogle Scholar
  5. Benotsch, E. G., Martin, A. M., Espil, F. M., Nettles, C. D., Seal, D. W., & Pinkerton, S. D. (2011). Internet use, recreational travel, and HIV risk behaviors in men who have sex with men. Journal of Community Health, 36, 398–405.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Benotsch, E. G., Wright, V. J., deRoon Cassini, T. A., Pinkerton, S. D., Weinhardt, L., & Kelly, J. A. (2006). Use of the Internet for HIV prevention by AIDS service organizations in the United States. Journal of Technology in Human Services, 24, 19–35.CrossRefGoogle Scholar
  7. Benotsch, E. G., Zimmerman, R. S., Cathers, L., McNulty, S., Pierce, J., Heck, T., et al. (2013). Non-medical use of prescription drugs, polysubstance use, and mental health in transgender adults. Drug and Alcohol Dependence, 132, 391–394.CrossRefPubMedGoogle Scholar
  8. Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103, 943–951.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Bogart, L. M., Wagner, G. J., & Galvan, F. H. (2010). Longitudinal relationships between antiretroviral treatment adherence and discrimination due to HIV-serostatus, race, and sexual orientation among African American men with HIV. Annals of Behavioral Medicine, 40, 184–190.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Bolding, G., Davis, M., Hart, G., Sherr, L., & Elford, J. (2006). Heterosexual men and women who seek sex through the Internet. International Journal of STD and AIDS, 17, 530–534.CrossRefPubMedGoogle Scholar
  11. Bowen, A. M., Williams, M. L., Daniel, C. M., & Clayton, S. (2008). Internet based HIV prevention research targeting rural MSM: Feasibility, acceptability, and preliminary efficacy. Journal of Behavioral Medicine, 31, 463–477.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Bradford, J., Reisner, S. L., Honnold, J. A., & Xavier, J. (2013). Experiences of transgender-related discrimination and implications for health: Results from the Virginia transgender health initiative study. American Journal of Public Health, 103, 1820–1829.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Brennan, J., Kuhns, L. M., Johnson, A. K., Belzer, M., Wilson, E. C., Garofalo, R., et al. (2012). Syndemic theory and HIV-related risk among young transgender women: The role of multiple, co-occurring health problems and social marginalization. American Journal of Public Health, 102, 1751–1757.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Buhi, E., Klinkenberger, N., McFarlane, M., Kachur, R., Daley, E. M., Baldwin, J., et al. (2013). Evaluating the Internet as a sexually transmitted disease risk environment for teens: Findings from the communication, health, and teens study. Sexually Transmitted Diseases, 40, 528–533.CrossRefPubMedGoogle Scholar
  15. Bull, S. S., Levine, D. K., Black, S. R., Schiege, S. J., & Santelli, J. (2012). Social media-delivered sexual health intervention: A cluster randomized controlled trial. American Journal of Preventive Medicine, 43, 467–474.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Caplan, S. E. (2007). Relations among loneliness, social anxiety, and problematic internet use. Cyberpsychology & Behavior, 10, 234–242.CrossRefGoogle Scholar
  17. Chen, S., McFarland, W., Thompson, H. M., & Raymond, H. F. (2011). Transmen in San Francisco: What do we know from HIV test site data? AIDS and Behavior, 15, 659–662.CrossRefPubMedGoogle Scholar
  18. Cunningham, S., & Kendall, T. D. (2011). Men in transit and prostitution: Using political conventions as a natural experiment. The B.E. Journal of Economic Analysis & Policy, 11. doi: 10.2202/1935-1682.2735.
  19. De Santis, J. P. (2009). HIV infection risk factors among male-to-female transgender persons: A review of the literature. Journal of the Association of Nurses in AIDS Care, 20, 362–372.CrossRefPubMedGoogle Scholar
  20. Derogatis, L. R. (2001). Brief symptom inventory 18, administration and scoring manual. San Antonio: Pearson.Google Scholar
  21. Dispenza, F., Watson, L. B., Chung, Y. B., & Brack, G. (2012). Experience of career-related discrimination for female-to-male transgender persons: A qualitative study. Career Development Quarterly, 60, 65–81.CrossRefGoogle Scholar
  22. Döring, N. M. (2009). The internet’s impact on sexuality: A critical review of 15 years of research. Computers in Human Behavior, 25, 1089–1101.CrossRefGoogle Scholar
  23. Dragowski, E. A., Halkitis, P. N., Moeller, R. W., & Siconolfi, D. E. (2013). Social and sexual contexts explain sexual risk taking in young gay, bisexual, and other men who have sex with men, ages 13–29 years. Journal of HIV/AIDS and Social Services, 12, 236–255.CrossRefGoogle Scholar
  24. Feinberg, L. (1992). Transgender liberation: A movement whose time has come. New York: World View Forum.Google Scholar
  25. Gillmore, M. R., Leigh, B. C., Hoppe, M. J., & Morrison, D. M. (2010). Comparison of daily and retrospective reports of vaginal sex in heterosexual men and women. Journal of Sex Research, 47, 279–284.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Glick, S. N., Winer, R. L., & Golden, M. R. (2013). Web-based sex diaries and young adult men who have sex with men: Assessing feasibility, reactivity, and data agreement. Archives of Sexual Behavior, 42, 1327–1335.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Grov, C., DeBusk, J. A., Bimbi, D. S., Golub, S. A., Nanin, J. E., & Parsons, J. T. (2007). Barebacking, the Internet, and harm reduction: An intercept survey with gay and bisexual men in Los Angeles and New York City. AIDS and Behavior, 11, 527–536.CrossRefPubMedGoogle Scholar
  28. Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D’Augelli, A. R., et al. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of Homosexuality, 58, 10–51.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Herbst, J. H., Jacobs, E. D., Finlayson, T. J., McKleroy, V. S., Spink Neumann, M., Crepaz, N., et al. (2008). Estimating HIV prevalence and risk behaviors of transgender persons in the United States: A systematic review. AIDS and Behavior, 12, 1–17.CrossRefPubMedGoogle Scholar
  30. Hirshfield, C., Chiasson, M. A., Joseph, H., Scheinmann, R., Johnson, W. D., Remien, R. H., et al. (2012). An online randomized controlled trial evaluating HIV prevention digital media interventions for men who have sex with men. PLoS One, 7, e46252.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Hollander, M., & Wolfe, D. A. (1999). Nonparametric statistical methods (2nd ed.) New York: Wiley.Google Scholar
  32. Horvath, K. J., Bowen, A. M., & Williams, M. L. (2006). Virtual and physical venues as contexts for HIV risk among rural men who have sex with men. Health Psychology, 25, 237–242.CrossRefPubMedGoogle Scholar
  33. Horvath, K. J., Iantaffi, A., Grey, J. A., & Bockting, W. (2012). A review of the content and format of transgender-related webpages. Health Communication, 27, 457–466.CrossRefPubMedPubMedCentralGoogle Scholar
  34. Kim, M., Kwon, K. N., & Lee, M. (2009). Psychological characteristics of internet dating service users: The effect of self-esteem, involvement, and sociability on the use of internet dating services. Cyberpsychology & Behavior, 12, 445–449.CrossRefGoogle Scholar
  35. Klein, H. (2014). Depression and HIV risk taking among men who have sex with other men (MSM) and who use the internet to find partners for unprotected sex. Journal of Gay & Lesbian Mental Health, 18, 164–189.CrossRefGoogle Scholar
  36. Ko, N. Y., Koe, S., Lee, H. C., Yen, C. F., Ko, W. C., & Hsu, S. T. (2012). Online sex-seeking, substance use, and risky behaviors in Taiwan: Results from the 2010 Asia Internet MSM sex survey. Archives of Sexual Behavior, 41, 1273–1282.CrossRefPubMedGoogle Scholar
  37. Kockott, G., & Fahrner, E. M. (1998). Male-to-female and female-to-male transsexuals: A comparison. Archives of Sexual Behavior, 17, 539–546.CrossRefGoogle Scholar
  38. Lee, K. T., Noh, M. J., & Koo, D. M. (2013). Lonely people are no longer lonely on social networking sites: The mediating role of self-disclosure and social support. Cyberpsychology, Behavior, and Social Networking, 16, 413–418.CrossRefGoogle Scholar
  39. Lenward, J. A., & Berrang-Ford, L. (2014). Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: A meta-analysis of observational studies. Sexually Transmitted Infections, 90, 290–296.CrossRefGoogle Scholar
  40. Liau, A., Millett, G., & Marks, G. (2006). Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men. Sexually Transmitted Diseases, 33, 576–584.CrossRefPubMedGoogle Scholar
  41. Martin, A. M., Benotsch, E. G., Cejka, A., & Luckman, D. (2014). Social responsibility, substance use, and sexual risk behavior in men who have sex with men. Journal of Homosexuality, 61, 251–269.CrossRefPubMedGoogle Scholar
  42. McFarlane, M., Bull, S., & Rietmeijer, C. (2002). Young adults on the Internet: Risk behaviors for sexually transmitted diseases and HIV. Journal of Adolescent Health, 31, 11–16.CrossRefPubMedGoogle Scholar
  43. Mehra, B., Merkel, C., & Bishop, A. P. (2004). The internet for empowerment of minority and marginalized users. New Media and Society, 6, 781–802.CrossRefGoogle Scholar
  44. Minichiello, V., Scott, J., & Callander, D. (2013). New pleasures and old dangers: Reinventing male sex work. Journal of Sex Research, 50, 263–275.CrossRefPubMedGoogle Scholar
  45. Morrison, C. M., & Gore, H. (2010). The relationship between excessive internet use and depression: A questionnaire-based study of 1,319 young people and adults. Psychopathology, 43, 121–126.CrossRefPubMedGoogle Scholar
  46. Napper, L. E., Fisher, D. G., Reynolds, G. L., & Johnson, M. E. (2010). HIV risk behavior self-report reliability at different recall periods. AIDS and Behavior, 14, 152–161.CrossRefPubMedPubMedCentralGoogle Scholar
  47. Newcomb, M. E., Ryan, D. T., Garofalo, R., & Mustanski, B. (2014). The effects of sexual partnership and relationship characteristics on three sexual risk variables in young men who have sex with men. Archives of Sexual Behavior, 43, 61–72.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Noar, S. M., Black, H. G., & Pierce, L. B. (2009). Efficacy of computer technology-based HIV prevention interventions: A meta-analysis. AIDS, 23, 107–115.CrossRefPubMedGoogle Scholar
  49. Nuttbrock, L., Bockting, W., Rosenblum, A., Hwahng, S., Mason, M., & Macri, M. (2013). Gender abuse, depressive symptoms, and HIV and other sexually transmitted infections among male-to-female transgender persons: A 3-year prospective study. American Journal of Public Health, 103, 300–307.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Pinkerton, S. D., Benotsch, E. G., & Mikytuck, J. M. (2007). When do simpler sexual behavior data collection techniques suffice? An analysis of consequent uncertainty in HIV acquisition risk estimates. Evaluation Review, 31, 401–412.CrossRefPubMedPubMedCentralGoogle Scholar
  51. Reisner, S. L., Perkovich, B., & Mimiaga, M. (2010). A mixed methods study of the sexual health needs of New England transmen who have sex with nontransgender men. AIDS Patient Care and STDs, 24, 501–513.CrossRefPubMedPubMedCentralGoogle Scholar
  52. Rosenbaum, M. S., Daunt, K. L., & Jiang, A. (2013). Craigslist exposed: The internet-mediated hookup. Journal of Homosexuality, 60, 505–531.CrossRefPubMedGoogle Scholar
  53. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.Google Scholar
  54. Rosenfeld, M. J., & Thomas, R. J. (2012). Searching for a mate: The rise of the internet as a social intermediary. American Sociological Review, 77, 523–547.CrossRefGoogle Scholar
  55. Rosser, B. R. S., Oakes, M. J., Horvath, K. J., Konstans, J. A., Danilenko, G. P., & Peterson, J. L. (2009). HIV sexual risk behavior by men who use the Internet to seek sex with men: Results of the Men’s INTernet Sex Study-II (MINTS-II). AIDS and Behavior, 13, 488–498.CrossRefPubMedGoogle Scholar
  56. Rowniak, S., Chesla, C., Dawson Rose, C., & Holzemer, W. L. (2011). Transmen: The HIV risk of gay identity. AIDS Education and Prevention, 23, 508–520.CrossRefPubMedGoogle Scholar
  57. Schnall, R., Travers, J., Rojas, M., & Carballo-Diéguez, A. (2014). eHealth interventions for HIV prevention in high-risk men who have sex with men: A systematic review. Journal of Medical Internet Research, 16, e134.CrossRefPubMedPubMedCentralGoogle Scholar
  58. Seal, D. W., Benotsch, E. G., Green, M., Snipes, D. J., Bull, S. S., Cejka, A., et al. (2014). The use of internet chat rooms to meet sexual partners: A comparison of non-heterosexually identified men with heterosexually-identified men and women. International Journal of Sexual Health. doi: 10.1080/19317611.2014.918921.PubMedCentralGoogle Scholar
  59. Sevelius, J. (2009). “There’s no pamphlet for the kind of sex I have”: HIV-related risk factors and protective behaviors among transgender men who have sex with nontransgender men. Journal of the Association of Nurses in AIDS Care, 20, 398–410.CrossRefPubMedPubMedCentralGoogle Scholar
  60. Shacham, E., & Cottler, L. B. (2010). Sexual behaviors among club drug users: Prevalence and reliability. Archives of Sexual Behavior, 39, 1331–1341.CrossRefPubMedPubMedCentralGoogle Scholar
  61. Smith, A., & Duggan, M. (2013). Online dating and relationships. Pew Research Center. Available at: http://www.pewinternet.org/2013/10/21/online-dating-relationships/.
  62. Stephens, S. C., Bernstein, K. T., & Philip, S. S. (2011). Male to female and female to male transgender persons have different sexual risk behaviors yet similar rates of STDs and HIV. AIDS and Behavior, 15, 683–686.CrossRefPubMedGoogle Scholar
  63. Testa, R. J., Sciacca, L. M., Wang, F., Hendricks, M. L., Goldblum, P., Bradford, J., et al. (2012). Effects of violence on transgender people. Professional Psychology Research and Practice, 43, 452–459.CrossRefGoogle Scholar
  64. Walther, J. B. (1996). Computer-mediated communication: Impersonal, interpersonal, and hyperpersonal interaction. Communication Research, 23, 3–43.CrossRefGoogle Scholar
  65. Whiteley, L. B., Brown, L. K., Swenson, R. R., Valois, R. F., Vanable, P. A., Carey, M. P., et al. (2012). African American adolescents meeting sex partners online: Closing the digital research divide in STI/HIV prevention. Journal of Primary Prevention, 33, 13–18.CrossRefPubMedPubMedCentralGoogle Scholar
  66. Wierckx, K., Elaut, E., Van Hoorde, B., Heylens, G., De Cuypere, G., Monstrey, S., et al. (2014). Sexual desire in trans persons: Associations with sex reassignment treatment. Journal of Sexual Medicine, 11, 107–118.CrossRefPubMedGoogle Scholar
  67. Ybarra, M. L., Bull, S. S., Prescott, T. L., Korchmaros, J. D., Bangsberg, D. R., & Kiwanuka, J. P. (2013). Adolescent abstinence and unprotected sex in CyberSenga, an Internet-based HIV prevention program: Randomized clinical trial of efficacy. PLoS One, 8, e70083. doi: 10.1371/journal.pone.0070083.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Eric G. Benotsch
    • 1
    • 2
    • 3
    Email author
  • Rick S. Zimmerman
    • 4
  • Laurie Cathers
    • 2
    • 3
  • Ted Heck
    • 5
  • Shawn McNulty
    • 6
  • Juan Pierce
    • 7
  • Paul B. Perrin
    • 1
  • Daniel J. Snipes
    • 1
  1. 1.Department of PsychologyVirginia Commonwealth UniversityRichmondUSA
  2. 2.Institute for Drug and Alcohol StudiesVirginia Commonwealth UniversityRichmondUSA
  3. 3.Institute for Women’s HealthVirginia Commonwealth UniversityRichmondUSA
  4. 4.College of NursingUniversity of Missouri–St. LouisSt. LouisUSA
  5. 5.Virginia Department of HealthRichmondUSA
  6. 6.Fan Free ClinicRichmondUSA
  7. 7.Minority Health ConsortiumRichmondUSA

Personalised recommendations