HIV and the transsexual

[peggygee]

1: Cult Health Sex. 2007 May-Jun;9(3):233-45. Links

'It's really a hard life': love, gender and HIV risk among male-to-female transgender persons.Melendez RM, Pinto R.

San Francisco State University Human Sexuality Studies, Center for Research on Gender and Sexuality, San Francisco, CA 94110, USA. rmelende@sfsu.edu

Scientific studies demonstrate high rates of HIV infection among male-to-female (MTF) transgender individuals and that stigma and discrimination place MTFs at increased risk for infection. However, there is little research examining how gender roles contribute to HIV risk. This paper reports on in-depth interviews with 20 MTFs attending a community clinic. Data reveal that stigma and discrimination create a heightened need for MTFs to feel safe and loved by a male companion and that in turn places them at a higher risk for acquiring HIV. Male-to-female transgender individuals appear to turn to men to feel loved and affirmed as women; their main HIV risk stems from their willingness to engage with sexual partners who provide a sense of love and acceptance but who also may also request unsafe sexual behaviours. A model illustrating how HIV risk is generated from stigma and discrimination is presented.

PMID: 17457728 [PubMed - indexed for MEDLINE]

[peggygee]

1: AIDS Care. 2002 Feb;14(1):127-34. Links
HIV among transgendered people.Kenagy GP.

Jane Addams College of Social Work, University of Illinois at Chicago, USA. kenagy@uic.edi

This study explores HIV status and HIV-related risk factors among transgendered people. A needs assessment survey developed with the help of transgendered people was used to conduct face-to-face interviews with 81 transgendered persons, 49 male-to-females (MTFs) and 32 female-to-males (FTMs). The findings indicate that HIV/AIDS is a serious health concern facing the transgender community. The majority of respondents engaged in at least one high risk sexual activity during the past three months, were willing to have high risk sex in the future and did not believe they were susceptible to infection. FTMs have a significantly lower level of AIDS knowledge than MTFs (p < 0.01). Over half (56.7%) of FTMs have not been tested for HIV/AIDS. Efforts to prevent the spread of HIV/AIDS among the transgender community are urgently needed. HIV/AIDS prevention must specifically target transgendered people, including FTMs who, despite being at risk, have been largely ignored.

PMID: 11798412 [PubMed - indexed for MEDLINE]

[peggygee]

1: Am J Public Health. 2004 Jul;94(7):1193-9. Links
HIV risk behaviors among male-to-female transgender persons of color in San Francisco.

Nemoto T, Operario D, Keatley J, Han L, Soma T.
Center for AIDS Prevention Studies, University of California, San Francisco, 94105, USA. tnemoto@psg.ucsf.edu

OBJECTIVES: The authors examined HIV risk behaviors among African American, Asian/Pacific Islander (API), and Latina male-to-female (MTF) transgender persons in order to improve HIV prevention programs. METHODS: Individual survey interviews with MTF transgender persons of color (n = 332; 112 African Americans, 110 Latinas, and 110 APIs) were conducted. RESULTS: Prevalence and correlates of receptive anal sex and unprotected receptive anal sex (URAS) varied by type of partner (primary, casual, or commercial sex partners). URAS with primary partners was associated with drug use before sex; URAS with casual partners was associated with HIV-positive status and drug use before sex; and URAS with commercial sex partners was associated with African American ethnicity and low income. CONCLUSIONS: Findings on current risk behaviors among MTF transgender persons provided meaningful implications for HIV prevention interventions.

PMID: 15226142 [PubMed - indexed for MEDLINE]

[whatsupwithat]

Thank you, Peggy! This is a huge issue in our community and one that is really easy to lose site of in the search for love and acceptance.

I'll also add this study which I've posted on here a few times:


National HIV Prevention Conference
Atlanta, Georgia - Jun 12-15, 2005

STD/HIV TRANSMISSION ISSUES
AMONG TRANSGENDER COMMERCIAL SEX WORKERS


ISSUE: HIV/STD transmission issues within the TG (transgender) community are misunderstood not only by the general population but by the transgender individual themselves. HIV/STD’s are also increasing at an alarming rate within the TG community.

SETTING: HIV/STD transmission routes unique to the TG individual, issues in testing and receiving care, psychosocial issues of risk taking behavior.

IMPLICATIONS: The Transgender community is a largely diverse group. Within the TG community are particular sub-groups that are more at risk than others. MTF (male to female transgender) sex workers have high rates of HIV infection, with overall rates of 35% in San Francisco in 1997 and 22% in Los Angeles in 1998. A study of MTF sex workers in Atlanta found that 68% tested positive for HIV. Infections among MTFs continue to rise, with an estimated rate of new infections of 3-8% per year. Injection drug use is also visible among MTFs, again putting them at high risk for HIV. In a San Francisco study, 18% of the respondents reported non-hormonal injection drug use in the past six months and half of this group shared syringes. MTFs may inject female hormones in order to feminize their bodies, putting them again at increased risk. Transphobia, or the pervasive social stigmatization of MTFs, greatly exacerbates their HIV risk. This intense stigmatization results in their social marginalization, which includes the denial of educational, employment and housing opportunities. It also creates multiple barriers to accessing health care. Such marginalization lowers MTFs’ self esteem, increases the likelihood of survival sex work and lessens the likelihood of safer sex practices. All of this can lead to high rates of HIV, STDs, drug use and attempted suicide. Pre-GRS (genital reassignment surgery) MTFs primarily have sex with men and are likely to engage in receptive anal sex, which puts them at increased risk. Some MTF commercial sex workers are willing to not use condoms with their paying partners if they are offered more money however, some studies show that most unprotected sex occurs with primary partners, not paying partners. Psychosocial factors such as poverty, low self-esteem, depression, rejection, and powerlessness are cited by many MTFs as barriers to sexual and drug risk reduction. For example, many MTFs state that they engage in unprotected sex because it validates their female gender identity and boosts their self-esteem. Commercial sex is largely a means of survival. For many MTFs, securing employment and housing are more pressing issues than HIV and must be addressed before HIV prevention efforts can be effective. Many trans-gender individuals do not access HIV prevention or health services due to the insensitivity of service providers and health care staff or fear of being revealed as transgender.

Special thanks to: Transgender Advisory Committee to the AIDS Office and the San Francisco Department of Public Health, AIDS Office Kristen Clements, Kerrily Kitano, and Willy Wilkinson San Francisco County Jail (San Bruno), Tenderloin AIDS Resource Center, Tom Waddell Clinic And the Center for AIDS Prevention Studies at the University of California San Francisco.

Copyright notice: The National HIV Prevention Conference is collaborative effort by the Centers for Disease Control and Prevention, a U.S. Government agency, and other governmental and non-government organizations. All abstracts published by the conference organizers are in the public domain and can be used without permission. Proper citation, however, is required.

[peggygee]

[peggygee]

1: AIDS Care. 2004 Aug;16(6):724-35. Links
Social context of HIV risk behaviours among male-to-female transgenders of colour.

Nemoto T, Operario D, Keatley J, Villegas D.
University of California at San Francisco, Center for AIDS Prevention Studies, San Francisco, CA, USA. tnemoto@psg.ucsf.edu

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 = 4 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.

PMID: 15370060 [PubMed - indexed for MEDLINE]

[peggygee]

1: Am J Public Health. 2007 Jun;97(6):1030-3. Epub 2007 Apr 26. Links
Male-to-female transgender and transsexual clients of HIV service programs in Los Angeles County, California.Edwards JW, Fisher DG, Reynolds GL.
California State University, Long Beach, USA.

Data on HIV risk were collected with the Countywide Risk Assessment Survey from 2126 participants; 92 were male-to-female transgender persons (i.e., cross-dressers, and those who identify with the opposite sex), and 9 were male-to-female transsexual individuals (i.e., those who have undergone gender-reassignment surgery or other procedures). Transgender-identified individuals were more likely than the rest of the sample to have received hormone injections, offensive comments, and HIV testing; injected hormones with a used needle; been Asian or American Indian; been paid for sexual intercourse; and lived in unstable housing but less likely to have used heroin. Transgender-identified individuals are at high risk for HIV infection because of reuse of needles and being paid for sexual intercourse.

PMID: 17463365 [PubMed - indexed for MEDLINE]

[peggygee]

1: Posit Aware. 1999 May-Jun;10(3):57.Links
Transgenderism and the AIDS epidemic.Sebastian C.

AIDS: Large numbers of transsexual/transgender (TS/TG) sex workers have HIV in comparison to others in the transgender community and to other sex workers. Issues contributing to these numbers include substance abuse, the uneven supply of hormones that can contribute to erratic behavior changes precipitating risky conduct, and needle sharing. Transsexual and transgender people often face a lack of acceptance, often have no insurance, and may avoid going to emergency rooms because of their fear of being discriminated against. Health care providers frequently do not understand the TS/TG community, and because of the abuse TS/TG individuals may endure from society, other sex workers, and police, they become mistrustful. These issues leave little time for TS/TG individuals to educate themselves on protection from HIV infection. The problem of TS/TG sex workers and AIDS has been largely ignored by both AIDS service agencies and government funding sources, despite the fact that this group is becoming one of the fastest growing groups within the HIV epidemic.



PMID: 11366771 [PubMed - indexed for MEDLINE]

[peggygee]

[peggygee]

Thank you, Peggy! This is a huge issue in our community and one that is really easy to lose site of in the search for love and acceptance.

I'm sure this is a very difficult topic for many to deal with, one that we
wished that we didn't have to even contemplate.

The sad reality is that it is a major problem in society in general, and the
transcommunity in particular.

However discussion and knowledge are our most powerful tools against
the spread of STIs.