Social context of HIV risk behaviours among male-to-female transgenders of colour

TLDR

The study aimed to investigate how social contexts of drug use and sexual behaviors contribute to HIV risk among male‑to‑female transgenders, with the goal of informing interventions that address relationship dynamics, stigma, discrimination, and community norms. Researchers conducted focus groups with 48 African American, Latina, and Asian/Pacific Islander MTF transgenders in San Francisco to gather qualitative data on these behaviors. Participants reported that unprotected sex with primary partners was motivated by emotional bonding and gender validation, condom use was more common in commercial sex, but financial pressures from transphobia and discrimination often undermined safer sex intentions, and drug use served as a coping strategy for stress related to relationships, sex work, and transition costs.

Abstract

To explore the social context of drug use and sexual behaviours that put male-to-female (MTF) transgenders at risk for HIV, focus groups were conducted consisting of African American, Latina and Asian and Pacific Islander MTF transgenders (N=48) who reside or work in San Francisco, California. Participants were likely to report having unprotected sex with primary partners to signify love and emotional connection, as well as to receive gender validation from their partners. In contrast, viewing sex work with customers as a business encouraged intentious to use condoms. Safer sex intentions with customers were frequently undermined by urgent financial needs, which stemmed from transphobia, employment discrimination and costly procedures associated with gender transition. Participants reported using drugs as a way to cope with or escape life stresses associated with relationships, sex work, transphobia and financial hardship. Interventions with at-risk MTF transgenders should address the interpersonal and social context of unsafe sex and drug use, particularly the unique roles of relationship issues with male partners, stigma, discrimination and community norms regarding sex work and drug use.