Clinical Update: Transgender HIV Prevention: A Model Education Workshop

  • Walter O. BocktingEmail author
  • B. R. Simon Rosser
  • Eli Coleman


A university-based human sexuality program collaborated with transgender and HIV/AIDS community organizations to develop one of the first HIV prevention programs targeting the transgender community. Based on focus group data outlining specific intervention needs, we designed, implemented, and evaluated a model prevention education workshop. The 4-hour workshop included large- and small-group meetings with presentations, discussions, role playing, and exercises based on the Health Belief Model, the Eroticizing Safer Sex approach to HIV prevention, and principles of personal and community empowerment. Transgender-sensitive audiovisual materials were developed; sexually explicit materials were incorporated. Transgender peer educators facilitated the workshop. This clinical update reviews the empirical and theoretical background of the workshop and discusses its development and implementation.

transgender HIV prevention education safer sex workshop AIDS 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Inciardi JA, Surratt HL. Male transvestite sex workers and HIV in Rio de Janeiro, Brazil. J Drug Iss 1997;27(1):135-46.Google Scholar
  2. 2.
    Minnesota Department of Health, AIDS/STD Prevention Services Section. Minnesota Comprehensive HIV/STD Prevention Plan 1995–1996. Minneapolis, Minnesota: Minnesota Department of Health, 1994.Google Scholar
  3. 3.
    Coleman E, Bockting WO, Gooren LJG. Homosexual and bisexual identity in sex-reassigned female-to-male transsexuals. Arch Sex Behav 1993;22(1):37-50.Google Scholar
  4. 4.
    Avery EN, Cole CM, Meyer WJ. Transsexuals and HIV/AIDS Risk Behaviors. Presented poster at the XIVth Harry Benjamin International Gender Dysphoria Symposium; September, 1995; Kloster Irsee, Bavaria, Germany.Google Scholar
  5. 5.
    Elifson KW, Boles J, Posey E, Sweat M, Darrow W, Elsea W. Male transvestite prostitutes and HIV risk. Am J Public Health 1993;83:260-62.Google Scholar
  6. 6.
    Galli M, Esposito R, Antinori S. HIV-1 infection, tuberculosis, and syphilis in male transsexual prostitutes in Milan, Italy. J Acquir Immune Defic Syndr Hum Retrovirol 1991;4(10):1006-08.Google Scholar
  7. 7.
    Kok LP, Ho ML, Heng BH, Ong YW. A psychosocial study of high risk subjects for AIDS. Singapore Med J 1990;31(6):573-82.Google Scholar
  8. 8.
    Tirelli U, Vaccher E, Covre P, Corso C, Serraino D, Rezza G. Condom use among transvestites in Italy. J Acquir Immune Defic Syndr Hum Retrovirol 1991;4(3):302-3.Google Scholar
  9. 9.
    Boles J, Elifson KW. The social organization of transvestite prostitution and AIDS. Soc Sci Med 1994;39(1):85-93.Google Scholar
  10. 10.
    Kelly JA. Changing HIV Risk Behavior: Practical Strategies. New York: The Guilford Press, 1995.Google Scholar
  11. 11.
    Peterson C, Szterenfeld C. Organizing a project with community-based health agents recruited from prostitutes in Rio de Janeiro. Public Health 1992;106:217-23.Google Scholar
  12. 12.
    Bockting WO, Kirk S, eds. Transgender and HIV: Risks, prevention, and care. Intern J Transgend [On-line serial] 1999;3(1+2). Available: Scholar
  13. 13.
    Ratnam KV. Efficacy of health education programme on awareness of AIDS among transsexuals. Singapore Med J 1990;31(1):33-7.Google Scholar
  14. 14.
    Bockting WO, Rosser BRS, Scheltema K. Transgender HIV prevention: Implementation and evaluation of a workshop. Health Educ Res Theory Pract 1999;14(2):177-83.Google Scholar
  15. 15.
    Bockting WO, Robinson BE, Rosser BRS. Transgender HIV prevention: Qualitative evaluation of a model prevention education program. J Sex Educ Therapy 1998;23(2):125-33.Google Scholar
  16. 16.
    Bockting WO, Rosser BRS, Coleman E. Transgender HIV prevention: Community involvement and empowerment. Intern J Transgend [On-line serial] 1999;3(1+2). Available: Scholar
  17. 17.
    Bockting WO, Coleman E. A comprehensive approach to the treatment of gender dysphoria. In: Bockting WO, Coleman E, eds. Gender Dysphoria: Interdisciplinary Approaches in Clinical Management. Binghamton, New York: Haworth Press, 1992:131-55.Google Scholar
  18. 18.
    Bockting WO. The assessment and treatment of gender dysphoria. Direct Clin Couns Psychol 1997;7(11):1-23.Google Scholar
  19. 19.
    Held J, Cournoyer C, Held C, Chilgren R. Sexual attitude reassessment: A training seminar for health professionals. Minn Med 1974;57:925-28.Google Scholar
  20. 20.
    Lief HL. Developments in the sex education of the physician. JAMA 1970;212:1864-67.Google Scholar
  21. 21.
    Rosser BRS, Dwyer SM, Coleman E, Miner M, Metz M, Robinson BE, Bockting WO. Using sexually explicit material in sex education: An eighteen year comparative analysis. J Sex Educ Therapy 1995;21(2):117-28.Google Scholar
  22. 22.
    Palacios-Jimenez L, Shernoff M. Faciliators' Guide to Eroticizing Safer Sex: A Psychoeducational Workshop Approach to Safer Sex Education. New York: Gay Men's Health Crisis, 1986.Google Scholar
  23. 23.
    Shernoff M, Bloom DJ. Perspectives: Designing effective AIDS prevention workshops for gay and bisexual men. AIDS Educ Prev 1991;3(1):31-46.Google Scholar
  24. 24.
    Shernoff M, Palacios-Jimenez L. AIDS prevention is the only vaccine available: An AIDS prevention education program. J Soc Work Human Sex 1988;6(2):135-50.Google Scholar
  25. 25.
    Kyes KB. The effect of a “safer sex” film as mediated by erotophobia and gender on attitudes toward condoms. J Sex Res 1990;27:297-303.Google Scholar
  26. 26.
    Solomon M, DeJong W. Recent sexually transmitted disease prevention efforts and their implications for AIDS health education. Health Educ Qu 1986;13:310-16.Google Scholar
  27. 27.
    Tanner WM, Pollack RH. The effect of condom use and erotic instructions on attitudes toward condoms. J Sex Res 1988;25(4):537-41.Google Scholar
  28. 28.
    Fisher WA. Predicting contraceptive behavior among university men: The role of emotions and behavioral intentions. J Appl Soc Psychol 1984;14(2):104-23.Google Scholar
  29. 29.
    Quadland M, Shattls W, Schuman R, Jacobs R, D'Eramo J. The 800 Men Project: A Report on the Design, Implementation, and Evaluation of an AIDS Prevention and Education Program. New York: Gay Men's Health Crisis, 1987.Google Scholar
  30. 30.
    Becker MH, ed. The health belief model and personal health behavior. Health Educ Monogr 1974;2:324-473.Google Scholar
  31. 31.
    Becker MH, Haefner DP, Kasl SV, Kirscht JP, Maiman LA, Rosenstock IM. Selected psychosocial models and correlates of individual health-related behaviors. Med Care 1977;15(5):27-46.Google Scholar
  32. 32.
    Janz K, Becker MH. The Health Belief Model: Adecade later. Health Educ Qu 1984;11:1-47.Google Scholar
  33. 33.
    Rosenstock IM, Strecher VJ, Becker MH. The Health Belief Model and HIV risk behavior change. In: DiClemente RJ, Peterson JL, eds. Preventing AIDS: Theories and Methods of Behavioral Interventions. New York: Plenum Press, 1994:5-24.Google Scholar
  34. 34.
    Montgomery SB, Joseph JG, Becker MH, Ostrow DG, Kessler RC, Kirscht JP. The Health Belief Model in understanding compliance with preventive recommendations for AIDS: How useful? AIDS Educ Prev 1989;1(4):303-23.Google Scholar
  35. 35.
    Abraham C, Sheeran P. Modelling and modifying young heterosexuals' HIV-preventive behaviour: A review of theories, findings and educational implications. Patient Educ Couns 1994;23:173-86.Google Scholar
  36. 36.
    Bandura A. Social Learning Theory. Englewood Cliffs, NJ: Prentice Hall, 1977.Google Scholar
  37. 37.
    Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Qu 1988;15: 175-83.Google Scholar
  38. 38.
    DiClemente RJ, Wingood GM. A randomized controlled trial of an HIV sexual risk-reduction intervention for young African-American women. JAMA 1995;274(16):1271-76.Google Scholar
  39. 39.
    Kegeles SM, Hays RB, Coates TJ. The Mpowerment Project: A community-level HIV prevention intervention for young gay men. Am J Public Health 1996;86(8):1129-36.Google Scholar
  40. 40.
    Kelly JA, Murphy D, Washington C, Wilson T, Koob J, Davis D, Lepezma G, Davantes, B. Effects of HIV/AIDS prevention groups for high-risk women in urban primary health care clinics. Am J Public Health 1994;84:1918-22.Google Scholar
  41. 41.
    Kelly JA, St. Lawrence JS, Hood HV, Brasfield TL. Behavioral interventions to reduce AIDS risk activities. J Consult Clin Psychol 1989;57(1):60-7.Google Scholar
  42. 42.
    Seibt AC, Ross MW, Freeman A, Krepcho M, Hedrich A, McAlister A, Fernandez-Esquer ME. Relationship between safe sex and acculturation into the gay subculture. AIDS Care 1995;7(Supplement 1):S85-8.Google Scholar
  43. 43.
    Freire P. Pedagogy of the Oppressed. New York: Continuum, 1970.Google Scholar
  44. 44.
    van Ryn M, Heaney CA. What's the use of theory? Health Educ Qu 1992;19(3):315-30.Google Scholar
  45. 45.
    Bockting WO, Robinson BE, Rosser BRS. Transgender HIV prevention: A qualitative needs assessment. AIDS Care 1998;10(4):505-25.Google Scholar
  46. 46.
    Catania JA, Kegeles SM, Coates TJ. Towards an understanding of risk behavior: An AIDS risk reduction model (ARRM). Health Educ Qu 1990;17(1):53-72.Google Scholar
  47. 47.
    McKusick L, Hortsman W, Coates TJ. AIDS and the sexual behavior reported by gay men in San Francisco. Am J Public Health 1985;75:493-96.Google Scholar
  48. 48.
    Kelly JA. Advances in HIV/AIDS education and prevention. Family Relations 1995;44:345-52.Google Scholar
  49. 49.
    Rosser BRS, Bockting WO, producers. Shoot Safe: HIV/AIDS Risk Reduction in the Use of Injection Paraphernalia [videotape]. Minneapolis, Minnesota: Program in Human Sexuality, 1300 South Second Street, Suite 180, Minneapolis,MN 55454, 1992.Google Scholar
  50. 50.
    Bockting WO, producer, Grandell S, editor, Bornstein K, script. Gender Defender with AIDS-Be-Gone Infomercial [videotape]. Minneapolis, Minnesota: Program in Human Sexuality, 1300 South Second Street, Suite 180, Minneapolis, MN 55454, 1992.Google Scholar
  51. 51.
    Bornstein K. Gender Defender Infomercial [video script]. Unpublished, 1992.Google Scholar
  52. 52.
    Coleman E, Bockting WO. “Heterosexual” prior to sex reassignment, “homosexual” afterwards:Acase-study of a female-to-male transsexual. J Psychol Human Sex 1988;1(2):69-82.Google Scholar
  53. 53.
    American College Health Association. Safer Sex [brochure]. Rockville, MD: American College Health Association, 1300 Piccard Drive, Suite 200, Rockville, MD 20850, 1990.Google Scholar
  54. 54.
    Jaccoma A, Armstrong J, Sprinkle A. Linda, Les, & Annie: The First Female-to-Male Transsexual Love Story [videotape]. New York: Linda, Les, & Annie, P.O. Box 1024, L.I.C., NY 11101, 1990.Google Scholar
  55. 55.
    Lane M (executive producer), Kay EC (producer and director). Condoms Are a Girl's Best Friend [videotape]. (Chicago, IL: Memory Lane, P.O. Box 146864, Chicago, IL 60614, 1991.Google Scholar
  56. 56.
    Kelly JA, Kalichman SC. Increased attention to human sexuality can improve HIV-AIDS prevention efforts: Key research issues and directions. J Consult Clin Psychol 1995;63(6):907-18.Google Scholar
  57. 57.
    Hein D, Kirk ME. Education and soul-searching: The Enterprise HIV prevention group. Intern J Transgend [On-line serial] 1999;3(1+2). Available: Scholar

Copyright information

© Gay and Lesbian Medical Association 2000

Authors and Affiliations

  • Walter O. Bockting
    • 1
    Email author
  • B. R. Simon Rosser
    • 1
  • Eli Coleman
    • 1
  1. 1.Department of Family Practice and Community Health, Medical SchoolUniversity of MinnesotaUSA

Personalised recommendations