HIV Risk Behaviors Among Male-to-Female Transgender Persons of Color in San Francisco

Abstract

Findings on current risk behaviors among MTF transgender persons provided meaningful implications for HIV prevention interventions.

Sex workers, fem queens, and cross-dressers: Differential marginalizations and HIV vulnerabilities among three ethnocultural male-to-female transgender communities in New York City

“…Because of the long history of extreme stigma experienced by members of the House Ball community, sex work, along with drug use as a coping mechanism for sex work, has become internalized within the community as a rite of passage. Young MTF members of the House Ball community must go through this rite of passage because of the perception that there is no alternative for them other than sex work and drug use-a finding similar to that of a study conducted in San Francisco on MTF people of color (Nemoto, Operario, Keatley, Han, et al, 2004). One member of the House Ball community stated, "You know when you first experience the transgender life, you want to see what they're [the streetwalkers] all about, where they hang out, what do they do.…”

“…For instance, MTF groups in San Francisco have been shown to engage in riskier sexual behavior-indicated by the number of sex partners in recent history, participation in commercial sex work, and having a primary partner who injected drugs-than men who have sex with men, nontransgender 4 heterosexual women, and women who have sex with women (Gwadz, Clatts, Leonard, & Goldsamt, 2004 ;Nemoto et al, 1999 ;Nemoto, Operario, Keatley, Han, et al, 2004 ;Nemoto, Operario, Keatley, & Villegas, 2004 ;Stephens, Scott, & Braithwaite, 1999 ;Sykes, 1999 ;Valenta, Elias, & Domurat, 1992 ;Weinberg, Shaver, & Williams, 1999). MTF people are also more likely than FTM people to have been incarcerated, homeless, and unemployed; to have engaged in sex work; and to have lower levels of education (Clements-Nolle, Marx, Guzman, & Katz, 2001 ;Kenagy, 2002Kenagy, , 2005Kenagy & Hsieh, 2005 ;Sevelius, Nemoto, Keatley, Ventura, & SenGupta, 2005 ).5…”

“…Asian and Pacific Islander data may not be conclusive, however, because many studies on MTF people have not translated their instruments into Asian languages, thereby often inadvertently excluding immigrant and undocumented Asian and Pacific Islanders who may be at high risk (Nemoto, Operario, Keatley, Han, et al; Nemoto, Operario, Keatley, & Villegas). HIV seroprevalence for White MTF people has been reported as 1% to 22% Kellogg, Clements-Nolle, Dilley, Katz, & McFarland, 2001;Kenagy, 2002Kenagy, , 2005Nemoto et al, 1999;Nemoto, Operario, Keatley, Han, et al;Nemoto, Operario, Keatley, & Villegas;Nuttbrock, 2006;Sevelius et al, 2005;Simon et al, 2000).…”

“…Although studies have been undertaken with MTF people, including MTF people of color, in urban settings, there has never been a public health study identifying MTF groups and comparatively analyzing them as distinct communities by situating transgender groups within their lifestyles and what we term ethnocultural community contexts. In fact, researchers often designate races as separate, abstract categories according to HIV seroprevalence and behavioral indicators, with little or no ethnosocial context (ClementsNolle et al, 2001;Nemoto et al 1999;Nemoto, Operario, Keatley, Han, et al, 2004;Nemoto, Operario, Keatley, & Villegas, 2004).…”

“…3 Although it is well known that transgender people are stigmatized in the United States-as seen in mainstream films such as Transamerica (Tucker, 2005) and The Silence of the Lambs (Demme, Harris, & Tally, 1991)-the transgender population remains understudied (Bockting, Robinson, & Rosser, 1998;Feldman & Bockting, 2003;Lombardi, 2001). Previous research either has viewed transgender people as one monolithic group or has separated them into abstract racial categories unconnected to communities and lifestyles (Bockting et al, 1998;Feldman & Bockting, 2003;Kenagy, 2002Kenagy, , 2005Lombardi, 2001;Nemoto, Luke, Mamo, Ching, & Patria, 1999;Nemoto, Operario, Keatley, Han, & Soma, 2004;Nemoto, Operario, Keatley, Nguyen, & Sugano, 2005;Nemoto, Operario, Keatley, & Villegas, 2004;Simon, Reback, & Bemis, 2000). This article, however, maps some of the different communities comprising the MTF population in New York City and positions them within specific social networks, cultures, neighborhoods, and lifestyles.…”