Condom-Protected Sex and Minority Stress: Associations with Condom Negotiation Self-Efficacy, “Passing” Concerns, and Experiences with Misgendering among Transgender Men and Women in Brazil

Abstract

This cross-sectional exploratory study aims to verify associations between condom-protected sex, condom negotiation self-efficacy, self-esteem, and four minority stressors (experiences with misgendering, “passing” concerns, anticipated prejudice, and perceived prejudice) among transgender men (TM) and transgender women (TW). 260 individuals (192 TW and 68 TM) residing in two Brazilian states participated in the study. Data was collected online and in two hospital programs for transgender people and included sociodemographic data, condom-protected sex, the Trans-Specific Condom/Barrier Negotiation Self-Efficacy (T-Barrier) Scale, the Rosenberg Self-Esteem Scale, and four minority stressors. Measures that were significantly associated with condom-protected sex were tested as independent variables in a linear regression model. The main results suggest that lower condom negotiation self-efficacy, higher “passing” concerns, and higher experiences with misgendering were predictors of lower frequency of condom-protected sex. These negative outcomes were found among both TM and TW, which justifies their inclusion in public health policies. Structural strategies and clinical interventions are suggested to address condom negotiation self-efficacy and “passing” concerns in transgender populations.

PrEP awareness and protective barrier negotiation among transgender people attracted to men in Aotearoa New Zealand

“…All eight items demonstrated high factor loading in a one‐factor construct which explained 65% of the variance in the Ontario sample [ 18 ]. Similar to previous studies [ 18 , 21 ], the internal consistency of the T‐Barrier Scale in the current dataset was high (Cronbach's α = 0.92).…”

“…For instance, Trans PULSE did not detect significant gendered differences between AFAB and AMAB groups [ 18 ] and a Brazilian study reported a higher perceived ability to negotiate protective barriers (e.g. condoms) among trans men than trans women [ 21 ]. Our study asserted the importance of examining the intersection of gender and sexual attraction, as we only found significant gendered differences among those attracted to men: trans women had higher certainty around negotiating protective barrier use than trans men and non‐binary AFAB people.…”

Behavioural survey and street-based HIV and HCV rapid testing programme among transgender sex workers

“…The high circulation of HIV among TGW-SW cannot be only and simply explained by high rates of risky sexual behaviours, such as unprotected receptive anal intercourse. Social marginalisation, lack of control on life and sexuality, low self-esteem, difficult access to healthcare, legal problems, stigma, discrimination, violence, mental illnesses and substance abuse are all intertwined factors that contribute to increasing the risk of HIV acquisition 14–17. In this respect, collection of behavioural information is important to identify specific health needs and to individualise diagnostic and preventive interventions.…”

Effectiveness of a Safe Sex Education Module in Improving Condom Use among People Living with HIV: A Randomised Controlled Trial

“…Few interventional studies have measured condom use; however, the studies used a wide range of measures and showed mixed results [ 7 , 8 , 19 , 20 , 21 ]. For instance, a study done in Nigeria found similar results when compared with the control group [ 19 ].…”