Structural disadvantage and HIV risk - comparing risk factors between trans women's partnerships with cis men and trans women sexual partners.

Erin C Wilson, Bow Suprasert, Dillon Trujillo, Sofia Sicro, Christopher J Hernandez, Caitlin M Turner, Willi McFarland, Sean Arayasirikul
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Abstract

Introduction: Little is known about differences in HIV risk for trans women by partner gender, particularly with respect to social determinants and partner-level circumstances that affect behavior. We examined differences in demographic, social determinants, and HIV-related risk behaviors for trans women with cis men and trans women sexual partners.

Materials and methods: Data are from a cross-sectional survey of trans women and their sexual partners conducted between April 2020 and January 2021. Interviews were held remotely during shelter-in-place due to Covid-19 via videoconference. Analysis characterizedassociations between HIV risk and protective behaviors comparing trans women with cisgender men partners to trans women with non-cisgender sexual partners.

Results: A total of 336 sexual partners were identified from 156 trans women. Trans women with cis men partners had significantly less education and employment and more incarceration and recidivism than trans women with trans women partners. Trans women and their cisgender men partners had shared experiences of unstable housing, incarceration, and HIV. Trans women with cisgender men partners reported significantly more sex exchange partners, receptive condomless sex, receptive or insertive condomless sex while using substances, and HIV infection compared to trans women with trans women partners.

Conclusions: Trans women with cisgender men sexual partners faced higher HIV risk than trans women with trans women sexual partners. These risks may be related to the social and economic drivers that both trans women and their cis men partners faced, including barriers to education and employment, along with incarceration and recidivism. Interventions focused on economic stability, workforce development and post incarceration re-entry support for housing and employment for trans women with cis men partners and the cisgender men partners as well may have the most impact on reducing HIV risk and incidence.

结构性不利因素与艾滋病毒风险--比较变性女性与同性男性的伴侣关系和变性女性性伴侣之间的风险因素。
导言:人们对不同性伴侣性别的变性女性感染 HIV 风险的差异知之甚少,尤其是在影响行为的社会决定因素和性伴侣层面的环境方面。我们研究了变性女性与同性和变性女性性伴侣在人口统计学、社会决定因素和 HIV 相关风险行为方面的差异。材料和方法:数据来自 2020 年 4 月至 2021 年 1 月期间对变性女性及其性伴侣进行的横截面调查。由于 Covid-19 的原因,访谈是在就地庇护期间通过视频会议远程进行的。分析显示,与有同性性伴侣的变性女性相比,与有非同性性伴侣的变性女性相比,变性女性的 HIV 风险和保护行为之间存在关联。结果:从 156 名变性女性中共识别出 336 名性伴侣。与拥有变性女性性伴侣的变性女性相比,拥有同性男性性伴侣的变性女性的受教育程度和就业率要低得多,而拥有变性女性性伴侣的变性女性的监禁率和累犯率要高得多。变性女性及其同性男性伴侣都有住房不稳定、入狱和感染艾滋病毒的经历。与有变性女性伴侣的变性女性相比,有变性男性伴侣的变性女性报告了更多的性交换伴侣、接受性无套性行为、使用药物时的接受性或插入性无套性行为以及 HIV 感染。结论:与有变性女性性伴侣的变性女性相比,有顺性男性性伴侣的变性女性面临更高的艾滋病病毒感染风险。这些风险可能与变性女性及其同性性伴侣所面临的社会和经济驱动因素有关,包括教育和就业障碍,以及监禁和累犯。干预措施的重点是经济稳定、劳动力发展和监禁后重返社会的支持,以帮助有同性性伴侣的变性女性和同性性伴侣的变性男性获得住房和就业,这可能会对降低艾滋病毒风险和发病率产生最大的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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