Background: To examine sexual violence across the lifespan among transgender and cisgender people living with HIV and its associations with recent risk behaviors.
Setting: Seven community-based sites serving priority populations disproportionately affected by HIV in the United States, including major metropolitan areas in the West and East Coast, as well as the suburban Mid-Atlantic and rural Southeastern regions.
Methods: From 2013 to 2016, baseline survey data were collected from participants (N = 583) of a multisite community-based HIV linkage to/retention in care study conducted at 7 sites across the United States. Adjusted mixed-effects logistic regression models with random effect for site-assessed associations of sexual violence and gender identity with risk outcomes including condomless sex, sex trade involvement, and substance use–related harms.
Results: One-third of participants reported a history of sexual violence; transgender [adjusted odds ratio (AOR) = 5.1, 95% confidence interval (CI): 2.6 to 10.1] and cisgender women (AOR = 3.8, 95% CI: 2.3 to 6.4) were more likely than cisgender men to experience sexual violence. Sexual violence was associated with experiencing drug-related harms (AOR = 2.6, 95% CI: 1.2 to 5.5). Transgender women were more likely than cisgender men to have sold sex (AOR = 9.3, 95% CI: 1.7 to 50.0).
Conclusions: A history of sexual violence is common among transgender and cisgender women PLWH, and it increases risk for drug-related harms. Transgender women are also more likely to report selling sex.
*Division of Global Public Health, Department of Medicine, Center on Gender Equity and Health, School of Social Work, San Diego State University, La Jolla, CA;
†Public Health Institute, Oakland, CA; and
‡Kaiser Permanente, Oakland, CA.
Correspondence to: Laramie R. Smith, PhD, Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine; 9500 Gilman Drive #0507, La Jolla, CA 92093-0507 (e-mail: laramie@ucsd.edu).
Supported by Kaiser Permanente (Grant Number 20030041). The development and dissemination of the current subanalyses were supported by an NIH-NIDA–funded career development award (K01 DA039767) and NIH-NIMHD Loan Repayment Program Award (L60 MD009353) to L.R.S. NIH NIDA-funded career development award (K01 DA036439) to L.U.
L.R.S., J.Y., L.U., D.P.T., Moller S. P., Ayyaluru S., T.N., Edmiston J. L., Ramos, M., Schwartz P. M., Caraballo A. X., A.R. Gender Identity, Sexual Violence, and HIV: Assessing gender-based disparities across the lifespan among a US sample of people living with HIV. Poster presented at the 20th annual US Conference on AIDS; September 16, 2017; Fort Lauderdale, FL. [Abstract 2173].
The authors have no funding or conflicts of interest to disclose.
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Received November 08, 2016
Accepted April 12, 2017
