Prior research has shown that male-to-female (MTF) transgender women of color in the United States have a high rate of HIV infection and often engage in sex work for economic survival. With the exception of studies on HIV prevalence and behavioral risk, little research exists to elucidate the social context and determinants of sex work and related health risks among these women. Through a qualitative analysis of seven focus groups with 48 transgender women of color, we examined why and how participants became involved in sex work, documented risks associated with sex work, and explored what motivated participants to remain in sex work. Participants reported on how social networks and cultural norms, immigration issues, and experiences of racism, sexism, and transphobia influenced their decisions to enter and the risks encountered in sex work. Findings revealed that transgender women of color who engage in sex work have unique needs and experiences that must be addressed through structural and social network-based interventions to minimize their vulnerability to social and public health harms.
The purpose of this paper is to report on the use of qualitative and quantitative research to develop an HIV/AIDS education intervention for MTF transgenders. Findings revealed that MTF transgenders have high prevalence of adverse health outcomes such as HIV, substance use, and psychological problems. MTF transgenders of color-African American, Latina, and Asian Pacific Islanders-experience heightened risk due to multiple stigmas associated with ethnicity and gender identity. Based on this evidence of need, we developed a series of transgender- specific HIV prevention, substance use and mental health treatment, and health education programs. Future health programs for stigmatized gender minorities, such as MTF transgenders, will benefit from conducting descriptive studies to identify the health needs of the community, and by linking research scientists, health providers, and community agencies to form a collaborative network for delivering evidence based and community sensitive services.
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