Little is known about distinct HIV/STD risks/prevention needs of female-to-male (FTM) transgender people. Reported HIV prevalence rates range from 2-3%; however, these studies predominately included men identified as heterosexual (transmen who have sex with women). Anecdotal evidence suggests a significant subgroup of transmen that engage in high-risk sex with non-transgender men (‘transMSM’).
Participants across the United States were recruited via transgender- focused conferences, listserves, and snowball sampling methods. Quantitative surveys (n=45) and qualitative interviews (n=15) were conducted to explore transMSM’s HIV-related risk behaviors, protective strategies, and perceptions of impact of transgender identity on sexual decisionmaking/ negotiation of safer sex with non-trans MSM.
Participants reported diverse sexual orientations and risk behaviors, including unprotected anal and vaginal sex with non-transgender men, substance use during sex, and sex work. HIV prevalence was 2%. Reported risk factors included barriers to negotiating safer sex with non-transgender men, such as unequal power dynamics, low self-esteem, and desire for inclusion in gay male communities. Protective strategies included meeting partners online to facilitate disclosure of transgender status and negotiation of safer sex, and participation in transgender men’s communities.
Current risk behaviors could lead to a significant rise in HIV prevalence among transMSM. Protective strategies must be better understood to reinforce them in prevention efforts. HIV prevention programs, especially those prioritizing gay men, need to tailor messages to include issues unique to transMSM and their non-trans male partners.
Conflict of Interest: None disclosed
Financial Support/Funding:This research was supported by the Center for AIDS Prevention Studies at UCSF, grant # P30 MH062246-06, funded by the National Institute of Mental Health (NIMH).
This lecture was recorded at The 19th WAS World Congress for Sexual Health - Sexual Health & Rights: A Global Challenge, Göteborg (Sweden) - June 21 – 25, 2009
more about this speaker
