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Syndemic Conditions, HIV Transmission Risk Behavior, and Transactional Sex Among Transgender Women

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Abstract

This study examined the effect of four syndemic conditions—namely, polydrug use, depression, childhood sexual abuse, and intimate partner violence—on rates of HIV transmission risk behavior (TRB) and separately, transactional sex among transgender women. TRB was defined as the number of condomless penetrative sex events with a casual or main partner of discordant or unknown HIV status. Using data from 212 transgender women in New York City, multivariable analyses revealed that, compared to those with no syndemic conditions, dramatically higher rates of recent HIV TRB events (ARR = 8.84, p < 0.001) and recent transactional sex events (ARR = 8.32, p < 0.001) were reported by participants with all four syndemic conditions. These findings highlight the importance of considering the role of syndemic conditions in HIV risk among transgender women, and the need for comprehensive psychosocial interventions to improve sexual health among this population.

Resumen

Este estudio examinó el impacto de cuatro condiciones sindémicas—principalmente, el uso de múltiples drogas, depresión, abuso sexual en la infancia, y violencia domestica, y cómo ellas impactan el comportamiento riesgoso en relación a la transmisión de VIH (CRT), y adicionalmente, el sexo transaccional entre mujeres transgénero. CRT se definió como el número de eventos en la cual se tuvo sexo penetrativo sin condón con una pareja casual o principal con estatus de VIH discordante o desconocido. Utilizando data de 212 mujeres transgénero en la ciudad de Nueva York, análisis multivariados mostraron tasas dramáticamente altas de eventos recientes de CRT (ARR = 8.84, p < 0.001) y eventos recientes de sexo transaccional (ARR = 8.32, p < 0.001) en el grupo de mujeres transgénero que reportaron sufrir de las cuatro condiciones sindémicas comparado con el grupo que reportó no sufrir de las cuatro condiciones. Los resultados enfatizan la importancia de considerar el rol de las condiciones sindémicas en mujeres transgénero que están en riesgo de contraer VIH, y la necesidad de las intervenciones psicosociales para mejorar la salud sexual en esta población.

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Acknowledgements

We would like to acknowledge other members of the T-Talk Study Team (H. Jonathon Rendina, Tyrel Starks, Ana Ventuneac, Ruben Jimenez, and Jonathan López Matos) and other current staff from the Center for HIV/AIDS Educational Studies and Training (Chris Hietikko, Tina Koo, Carlos Ponton) who were integrally involved in the development, implementation, and reporting of this study. We would also like to thank the staff at Callen-Lorde Community Health Center (Asa Radix, Linda Li, Makada Bernard), and the LGBT Center in New York City (Carrie Davis and Cristina Herrera). Finally, special thanks to Drs. Richard Jenkins and Pamela Goodlow at NIDA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding

T-Talk was funded by the National Institutes of Health (R01 DA 034661: Jeffrey T. Parsons, Principal Investigator).

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Authors and Affiliations

  1. Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY, USA

    Jeffrey T. Parsons, Nadav Antebi-Gruszka, Brett M. Millar, Demetria Cain & Sitaji Gurung

  2. Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave., New York, NY, 10065, USA

    Jeffrey T. Parsons

  3. Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA

    Jeffrey T. Parsons

  4. Mental Health Counseling, Department of Psychology, City College of the City University of New York (CUNY), New York, NY, USA

    Nadav Antebi-Gruszka

  5. Community Health Sciences, University of Illinois-Chicago School of Public Health, Chicago, IL, USA

    Demetria Cain

  6. CUNY School of Public Health and Health Policy, New York, NY, USA

    Sitaji Gurung

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  1. Jeffrey T. Parsons
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  2. Nadav Antebi-Gruszka
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Correspondence to Jeffrey T. Parsons.

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Ethical Approval

All study protocols were approved by the City University of New York (CUNY) Institutional Review Board.

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All participants provided their consent to take part in the study.

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Parsons, J.T., Antebi-Gruszka, N., Millar, B.M. et al. Syndemic Conditions, HIV Transmission Risk Behavior, and Transactional Sex Among Transgender Women. AIDS Behav 22, 2056–2067 (2018). https://doi.org/10.1007/s10461-018-2100-y

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