Background: This study is among the first to examine factors associated with HIV-related sexual risk among transgender men and other transmasculine persons who are gay, bisexual, or have sex with men (T-GBMSM).
Methods: In 2009–2010, 433 transgender people in Ontario, Canada, participated in a multimode respondent-driven sampling survey, including 158 T-GBMSM. Analyses were weighted using respondent-driven sampling II methods to adjust for differential recruitment probabilities; confidence intervals (CI) were adjusted for clustering by shared recruiter. Prevalence ratios (PR) for associations with past-year high sexual risk (condomless intercourse outside a seroconcordant monogamous relationship) were estimated using average marginal predictions from logistic regression.
Results: Of T-GBMSM (mean age = 29.8; 52% living full time in felt gender; 25% Aboriginal or persons of color; 0% self-reported HIV positive), 10% had high sexual risk activity in the past year. Among the 34% with a past-year cisgender (non-transgender) male sex partner, 29% had high sexual risk. In multivariable analyses, older age, childhood sexual abuse (adjusted PR, APR = 14.03, 95% CI: 2.32 to 84.70), living full time in one's felt gender (APR = 5.20, 95% CI: 1.11 to 24.33), and being primarily or exclusively attracted to men (APR = 5.54, 95% CI: 2.27 to 13.54) were each associated with sexual risk. Of psychosocial factors examined, past-year stimulant use (APR = 4.02, 95% CI: 1.31 to 12.30) and moderate depressive symptoms (APR = 5.77, 95% CI: 1.14 to 29.25) were associated with higher sexual risk.
Conclusions: T-GBMSM seem to share some HIV acquisition risk factors with their cisgender counterparts. HIV prevention interventions targeting T-GBMSM who are predominantly attracted to men and interventions addressing sequelae of childhood sexual abuse may be warranted.
*Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; and
†Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada.
Correspondence to: Ayden I. Scheim, BA, Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, K201 Kresge Building London, London, ON N6A 5C1, Canada (e-mail: firstname.lastname@example.org).
Supported by operating grants from the Canadian Institutes of Health Research, Institute of Gender and Health (Funding Reference MOP-106478) and HIV/AIDS Community-Based Research Program (Funding Reference 167492). A.I.S. was supported by Trudeau Foundation and Vanier Canada Graduate Scholarships.
Presented at the Canadian Association for HIV Research Conference, May 13, 2016, Winnipeg, MB, Canada.
The authors have no conflicts of interest to disclose.
Received June 07, 2016
Accepted October 14, 2016