Heterogeneity in HIV/Sexually Transmitted Infection Prevalence and Prevention Among the Partners of Transgender and Nonbinary People.
Journal
Sexually transmitted diseases
ISSN: 1537-4521
Titre abrégé: Sex Transm Dis
Pays: United States
ID NLM: 7705941
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
medline:
17
4
2023
pubmed:
8
3
2023
entrez:
7
3
2023
Statut:
ppublish
Résumé
Transgender and nonbinary (TNB) people are diverse in their sexual orientation and partnerships. We describe the epidemiology of HIV/sexually transmitted infection (STI) prevalence and prevention utilization among the partners of TNB people in Washington State. We pooled data from five 2017 to 2021 cross-sectional HIV surveillance data sources to generate a large sample of TNB people and cisgender people who had a TNB partner in the past year. We described characteristics of recent partners of trans women, trans men, and nonbinary people and used Poisson regression to assess if having a TNB partner was associated with self-reported HIV/STIs prevalence, testing, and preexposure prophylaxis (PrEP) use. Our analysis included 360 trans women, 316 trans men, 963 nonbinary people, 2896 cis women, and 7540 cis men. Overall, 9% of sexual minority cis men, 13% of sexual minority cis women, and 36% of TNB participants reported having any TNB partners. There was significant heterogeneity in HIV/STI prevalence, testing, and PrEP use among the partners of TNB people by study participant gender and the gender of their sex partners. In regression models, having a TNB partner was associated with a higher likelihood of HIV/STI testing and PrEP use but was not associated with higher HIV prevalence. We observed significant heterogeneity in HIV/STI prevalence and preventative behaviors among the partners of TNB people. Given that TNB people are diverse in their sexual partnerships, there is a need to better understand individual-, dyad-, and structural-level factors that facilitate HIV/STI prevention across these diverse partnerships.
Sections du résumé
BACKGROUND
Transgender and nonbinary (TNB) people are diverse in their sexual orientation and partnerships. We describe the epidemiology of HIV/sexually transmitted infection (STI) prevalence and prevention utilization among the partners of TNB people in Washington State.
METHODS
We pooled data from five 2017 to 2021 cross-sectional HIV surveillance data sources to generate a large sample of TNB people and cisgender people who had a TNB partner in the past year. We described characteristics of recent partners of trans women, trans men, and nonbinary people and used Poisson regression to assess if having a TNB partner was associated with self-reported HIV/STIs prevalence, testing, and preexposure prophylaxis (PrEP) use.
RESULTS
Our analysis included 360 trans women, 316 trans men, 963 nonbinary people, 2896 cis women, and 7540 cis men. Overall, 9% of sexual minority cis men, 13% of sexual minority cis women, and 36% of TNB participants reported having any TNB partners. There was significant heterogeneity in HIV/STI prevalence, testing, and PrEP use among the partners of TNB people by study participant gender and the gender of their sex partners. In regression models, having a TNB partner was associated with a higher likelihood of HIV/STI testing and PrEP use but was not associated with higher HIV prevalence.
CONCLUSIONS
We observed significant heterogeneity in HIV/STI prevalence and preventative behaviors among the partners of TNB people. Given that TNB people are diverse in their sexual partnerships, there is a need to better understand individual-, dyad-, and structural-level factors that facilitate HIV/STI prevention across these diverse partnerships.
Identifiants
pubmed: 36881439
doi: 10.1097/OLQ.0000000000001796
pii: 00007435-202305000-00006
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
280-287Subventions
Organisme : NIAID NIH HHS
ID : F31 AI152542
Pays : United States
Informations de copyright
Copyright © 2023 American Sexually Transmitted Diseases Association. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest and Sources of Funding: The authors have no other conflicts of interest. This work was funded by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health through grant number F31AI152542 awarded to D.M.T. This work was also supported by the American Sexually Transmitted Diseases Association and the Northwest Center for Public Health Practice at the University of Washington's School of Public Health.
Références
Poteat T, Malik M, Wirtz AL, et al. Understanding HIV risk and vulnerability among cisgender men with transgender partners. Lancet HIV 2020; 7:e201–e208.
Hassan A, Wertheim JO, Blumenthal JS, et al. Characteristics of a cohort of high-risk men who have sex with men on pre-exposure prophylaxis reporting transgender sexual partners. Medicine (Baltimore) 2019; 98:e18232.
Hall GC, Young A, Krakauer C, et al. Sexual risk behaviors among black men who have sex with men who also report having sex with transgender partners: Analysis of HIV Prevention Trials Network (HPTN) 061 study. AIDS Educ Prev 2017; 29:418–431.
Skeen SJ, Starks TJ, Jimenez RH, et al. Heterosexual cisgender men partnered with transgender women exhibit higher HIV/STI sexual risk than their gay, bisexual, and queer counterparts: Findings from a U.S.-based convenience sample recruited online. AIDS Behav 2021; 25:3279–3291.
Gamarel KE, Sevelius JM, Reisner SL, et al. Relationship stigma and HIV risk behavior among cisgender men partnered with transgender women: The moderating role of sexual identity. Arch Sex Behav 2020; 49:175–184.
Poteat T, Reisner SL, Radix A. HIV epidemics among transgender women. Curr Opin HIV AIDS 2014; 9:168–173.
Reisner SL, White Hughto JM, Pardee D, et al. Syndemics and gender affirmation: HIV sexual risk in female-to-male trans masculine adults reporting sexual contact with cisgender males. Int J STD AIDS 2016; 27:955–966.
Rowniak S, Chesla C, Rose CD, et al. Transmen: The HIV risk of gay identity. AIDS Educ Prev 2011; 23:508–520.
Scheim AI, Bauer GR, Travers R. HIV-related sexual risk among transgender men who are gay, bisexual, or have sex with men. J Acquir Immune Defic Syndr 2017; 74:e89–e96.
Feldman J, Romine RS, Bockting WO. HIV risk behaviors in the U.S. transgender population: Prevalence and predictors in a large internet sample. J Homosex 2014; 61:1558–1588.
Deutsch MB, Reisner SL, Peitzmeier S, et al. Recent penile sexual contact is associated with an increased odds of high-risk cervical human papillomavirus infection in transgender men. Sex Transm Dis 2020; 47:48–53.
Pletta DR, White Hughto JM, Peitzmeier S, et al. Individual- and partnership-level correlates of protective barrier use in a sample of transmasculine adults with diverse sexual partnerships. AIDS Patient Care STDS 2020; 34:237–246.
Cleere EF, Fairley CK, McGrath L, et al. Sex with a transgender or gender diverse person among patients attending a sexual health centre in Melbourne, Australia. Sex Transm Infect 2019; 95:46–52.
Wilson EC, Chen YH, Raad N, et al. Who are the sexual partners of transgender individuals? Differences in demographic characteristics and risk behaviours of San Francisco HIV testing clients with transgender sexual partners compared with overall testers. Sex Health 2014; 11:319–323.
Agénor M, White Hughto JM, Peitzmeier SM, et al. Gender identity disparities in pap test use in a sample of binary and non-binary transmasculine adults. J Gen Intern Med 2018; 33:1015–1017.
Dadasovich R, Auerswald C, Minnis AM, et al. Testosterone and sexual risk among transmen: A mixed methods exploratory study. Cult Health Sex 2017; 19:256–266.
McFarland W, Wilson EC, Raymond HF. HIV prevalence, sexual partners, sexual behavior and HIV acquisition risk among trans men, San Francisco, 2014. AIDS Behav 2017; 21:3346–3352.
Poteat T, German D, Flynn C. The conflation of gender and sex: Gaps and opportunities in HIV data among transgender women and MSM. Glob Public Health 2016; 11(7–8):835–848.
Sevelius JM, Keatley J, Calma N, et al. ‘I am not a man’: Trans-specific barriers and facilitators to PrEP acceptability among transgender women. Glob Public Health 2016; 11(7–8):1060–1075.
Ayer A, Perez-Brumer A, Segura ER, et al. Let's talk about sex: The impact of partnership contexts on communication about HIV Serostatus and condom use among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. AIDS Behav 2021; 25:2139–2153.
Reisner SL, Menino D, Leung K, et al. “Unspoken agreements”: Perceived acceptability of couples HIV testing and counseling (CHTC) among cisgender men with transgender women partners. AIDS Behav 2019; 23:366–374.
Gamarel KE, Reisner SL, Laurenceau JP, et al. Gender minority stress, mental health, and relationship quality: A dyadic investigation of transgender women and their cisgender male partners. J Fam Psychol 2014; 28:437–447.
Emlet CA, Fredriksen-Goldsen KI, Kim HJ, et al. The relationship between sexual minority stigma and sexual health risk behaviors among HIV-positive older gay and bisexual men. J Appl Gerontol 2017; 36:931–952.
Sevelius JM. Gender affirmation: A framework for conceptualizing risk behavior among transgender women of color. Sex Roles 2013; 68(11–12):675–689.
Reisner SL, Moore CS, Asquith A, et al. Gender non-affirmation from cisgender male partners: Development and validation of a brief stigma scale for HIV research with transgender men who have sex with men (trans MSM). AIDS Behav 2020; 24:331–343.
Scott D. Stress and coping amongst cisgender male partners of transgender women. Cult Health Sex 2020;24:196–209.
Restar AJ, Surace A, Ogunbajo A, et al. The HIV-related risk factors of the cisgender male sexual partners of transgender women (MSTW) in the United States: A systematic review of the literature. AIDS Educ Prev 2019; 31:463–478.
Lewis T, Doyle DM, Barreto M, et al. Social relationship experiences of transgender people and their relational partners: A meta-synthesis. Soc Sci Med 2021; 282:114143.
Siboni L, Rucco D, Prunas A, et al. “We Faced Every Change Together”. Couple's intimacy and sexuality experiences from the perspectives of transgender and non-binary individuals' partners. J Sex Marital Ther 2022; 48:23–46.
Fuller KA, Riggs DW. Intimate relationship strengths and challenges amongst a sample of transgender people living in the United States. Sex Relatsh Ther 2019; 36:399–412.