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Associations Between Gender Identity Control, Gender Identity Non-Verification, and Health Risks among Trans Women of Color Living with HIV

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Abstract

This study applied Identity Theory (IT) metrics to data gathered from a sample of trans women of color living with HIV to determine whether measures of identity control and/or identity non-verification were associated with trans women’s self-reported health risks. From February 2014 through August 2016, 139 HIV-positive trans women were enrolled. Cross-sectional time-series regressions indicated that identity control and identity non-verification were both associated with self-reported behavioral and health outcomes. Increased gender identity control was associated with decreased drug and alcohol use (multiple Logit [L]; all p < .05) and decreased likelihood of self-reported infection with a sexually transmitted infection (STI; multiple L; all p < .05); increased perceived identity non-verification was associated with increased severity of depression symptoms (b = 0.09) as well as increased odds of engagement in exchange sex (L = 0.32), increased drug and alcohol use (multiple L p > .05), and increased likelihood of self-reported infection with viral STIs (Lgenital warts = 0.49; Lherpes = 0.69). These findings indicate IT may be a useful theoretical framework through which to understand and analyze behavior among trans women of color living with HIV. Identity verification dynamics in particular may be useful mechanisms to explain engagement in several potentially harmful behaviors.

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Acknowledgements

This study was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number H97HA24968 in the last annual award amount of $285,757 awarded to Friends Research Institute (PI: C. Reback). No percentage of this study was financed with non-governmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the US Government. Dr. Reback acknowledges additional support from the National Institute of Mental Health (P30 MH58107).

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  1. Friends Research Institute Inc., 6910 Santa Monica Blvd., Los Angeles, CA, 90038, USA

    Jesse B. Fletcher & Cathy J. Reback

  2. Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, CA, USA

    Cathy J. Reback

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  1. Jesse B. Fletcher
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  2. Cathy J. Reback
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Correspondence to Jesse B. Fletcher.

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Fletcher, J.B., Reback, C.J. Associations Between Gender Identity Control, Gender Identity Non-Verification, and Health Risks among Trans Women of Color Living with HIV. Arch Sex Behav 51, 2003–2014 (2022). https://doi.org/10.1007/s10508-021-02264-6

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