Many female-to-male transgender individuals, or transmen, are situated within the gay community, one of the highest risk communities for HIV, yet there has been little research regarding the experience of risk for these transmen. Seventeen transmen were interviewed regarding their sexuality and HIV risk behavior. Fourteen of the 17 reported having non-trans gay men as sexual partners. Risk behaviors included not using condoms with multiple partners who were HIV-positive, or of unknown HIV status. Aspects of risk included the unfamiliarity of the gay community and the lack of safe sex negotiating skills. The dynamics of acceptance and rejection between transmen and non-trans gay men impacted risk by compromising safety. Incorrect assumptions regarding transmen, non-trans gay men, and risk included beliefs that neither person could be at risk. Other aspects included the impact of testosterone on sexual behavior, the changed bodies of transmen, and sex work.Many female-to-male (FTM) transgender persons, or transmen, are at high risk for HIV infection. This has been overshadowed to a great extent by the HIV risk and prevalence among male-to-female (MTF) transgender persons, or transwomen. However, there has been some recognition that many transmen identify with the gay community and have non-trans gay men as sex partners (Clements-Nolle, Marx, Guzman, & Katz, 2001;Herbst et al., 2008;Sevelius, 2009). The San Francisco Department of Public Health recently included TMSM (transmen who have sex with non-trans men) within the larger HIV risk group MSM. HIV prevalence among MSM in San Francisco was recently estimated to be 24.3% (Scheer et al., 2008), and HIV was characterized as being hyperendemic in the gay community. The Centers for Disease Control and Prevention reported at the 2010 National STD Prevention Conference that gay men are 44 times more likely to acquire HIV than other men (Roehr, 2010). It is unknown if these statistics apply equally to transmen. This study was conducted in order to understand and explicate the situated HIV risk of transmen who identify as gay.
As the HIV epidemic enters its third decade in the United States, there have been few changes in the demographics of the populations most affected by HIV. Twenty years of HIV has resulted in changing attitudes toward prevention and infection in the population of men who have sex with men (MSM). This article presents a review of the recent research regarding HIV risks and attitudes among MSM and reports on several trends that have repeatedly emerged from the literature. Concepts such as safe sex, treatment optimism, and serosorting have recently become common among MSM communities and present a challenge to all who work in HIV prevention. Suggestions are made regarding implications for nursing and areas for future research.
Female-to-male (FTM) transgender persons are often assumed to have been lesbian in sexual orientation prior to transition and to have maintained a primary attraction for women after transition. However, limited research and anecdotal information from clinicians who work with FTM have indicated that many identify as gay men post-transition. This article described the results of a qualitative study that employed interviews with 17 FTM in order to understand their experience of transition and sexual orientation. Of the 17 participants, seven identified as lesbian prior to transition, three as heterosexual, and seven as bisexual or queer. After transition, 10 identified as gay men and the remaining seven identified as bisexual or queer. Four patterns of sexual behavior emerged from the data and were described and discussed. These patterns were named steadfast, aligned, shifted, and fluid. These findings bring additional options to the belief that there are two distinct types of transgender: a homosexual subtype and a nonhomosexual subtype.
The study examined the attitudes and knowledge of transgender men (trans men) regarding pre-exposure prophylaxis (PrEP) for HIV. Three focus groups of trans men were conducted with a trans male facilitator for a total of 21 participants. Six themes were identified; the range of information about PrEP and possible side effects, the economic realities for trans men, finding a trans-competent provider, trans male sexuality, the importance of contraception, and condom use. Despite identified risk and some information that has been disseminated, many trans men still lack adequate information regarding PrEP. There exist significant barriers to PrEP access for trans men. Participants commented that many providers avoid important discussions regarding sexuality and contraception. The education of health care professionals must include competency in working with transgender populations. More research is needed with regard to interactions between PrEP, testosterone, and hormonal contraception.The United States has witnessed a shift in HIV prevention practices over the past several years. The prevention techniques that had been employed since the beginning of the epidemic focused on behavior change (Noar, 2007). This meant the promotion of condoms for safer sex and engaging high-risk individuals in intensive behavior change counseling, among other interventions. The current shift has been away from individual behavioral approaches to more community-based biological approaches that include testing and immediate treatment and the lowering of the community viral load to ensure that transmission is significantly decreased (Centers for Disease
A convenience sample of 90 nursing students participated in an online survey measuring homophobia or sexual prejudice. Significantly higher scores were seen among those who endorsed the belief that being gay was a matter of personal choice, did not have a friend or family member who was gay or lesbian, and endorsed religiosity. A significantly higher level of sexual prejudice was seen among those who identified as non-Catholic Christians when compared to other religions. Asian/Pacific Islanders showed significantly higher scores on the scales compared to non-Hispanic Caucasian students. Nursing education should focus on those aspects of homophobia amenable to change.
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