The New York City House Ball community consists of social networks of racial/ethnic minority gay, lesbian or bisexual men and women, and transgender persons. HIV seroprevalence and interview data were obtained from a sample of community members to identify statistical differences in HIV prevalence, risk behavior, and psychosocial stressors between men who have sex with men (MSM) and transgender women. Of 301 MSM and 60 transgender women, 20% were HIV-infected and 73% were unaware of their infection, but rates did not differ by gender. Risk behavior and stressors were common in both groups, but transgender women were more likely to report exchange sex, stigmatization, and stressful life events. High rates of risk behavior and HIV in this special community warrant relevant HIV testing and prevention services. Transgender women in the community may be at even greater risk for HIV infection due to behaviors compounded by substantial psychosocial stressors.

Culturally specific community-level prevention efforts are warranted to reduce risk behaviors and increase the frequency of HIV testing in New York City's house ball community.

Limited research has been conducted on threats or violence by family members and sexual partners against young men who have sex with men (MSM). Young MSM, aged 15-22 years, who attended public venues in New York City were enrolled in an anonymous, cross-sectional HIV seroprevalence and risk-behavior study. About two-thirds (68%) of the young MSM reported ever experiencing threats or violence from either family or partners and 25% reported threats or violence by both family and partners. In multivariate analysis, threats or violence by partners was significantly associated with older age, a history of forced sex and a history of running away from home. Recent unprotected anal sex and club drug use were significantly associated with a history of threats or violence by both family and partners. HIV prevention interventions need to include multiple factors that may have an impact on risk, including substance use and abuse, anti-violence and other mental-health issues.

No abstract