Gender Abuse and Incident HIV/STI Among Transgender Women in New York City: Buffering Effect of Involvement in a Transgender Community.
In a 3 year prospective study of 230 transgender women from the New York City Area, we further examined associations of gender-related abuse with HIV sexual risk behavior and incident HIV/STI, focusing here and the extent to which these associations are buffered by involvement in a transgender community. Largely consistent with the prior study, gender abuse was longitudinally associated with unprotected receptive anal intercourse (URAI) with casual and commercial sex partners, and the presumed biological outcome of this behavioral risk, new cases of HIV/STI. Both of these associations, gender abuse with URAI and HIV/STI, were significantly buffered by transgender community involvement (interaction effects). However, independent of these interaction effects, transgender community involvement was also positively associated with URAI and HIV/STI (direct effects). HIV prevention in this population should emphasize the benefits of interactions with transgender peers while also emphasizing the importance of resisting normative permission for HIV risk behavior from these same peers.