Use of the Internet to Meet Sexual Partners, Sexual Risk Behavior, and Mental Health in Transgender Adults

Abstract

The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.

Opportunities and Gaps in Primary Care Preventative Health Services for Transgender Patients: A Systematic Review

“…10,22 Twenty-one articles included samples from the West Coast, 8,11,23–41 17 included samples from the East Coast, 12,22,29,38,42–54 3 from the Midwest, 8,29,38 3 from the South, 10,55,56 and 1 each from Hawaii 57 or Mountain states 29 (multiple studies included samples from more than one region). One study included a national sample from an online survey and did not specify the location of participants.…”

“…10,25,26,39,44,45,55 Six studies compared either transgender men or transgender women to cisgender people. 27,28,38,47,48,56 Five studies compared transgender people to cisgender people, but did not specify the gender identity of the transgender group, or used suspect and unreliable measures to determine participant's gender identity (see Discussion section).…”

“…17 Based on the findings from this systematic review and other reviews that included international samples, there are specific populations of transgender women who are at greater risk for contracting HIV. 19 Being African American is independently associated with increased likelihood of being HIV positive, 25,30 as is engaging in sex work, 55 illicit drug use, 25,36,55 and experiencing gender-based violence. 12,46 Interestingly, one study used a cisgender comparison sample matched for age, race, and socioeconomic status (SES) and found no significant differences in rates of HIV between groups, 51 highlighting the importance of considering comparison samples when conducting transgender health research.…”

“…8,31 Being HIV positive was also associated with increased likelihood of CRAI, independent of partner status, 11,31 as was the use of Internet dating websites or apps. 55 Those with high self-efficacy or self-esteem are less likely to engage in CRAI. 32,40,43 Engaging in CRAI may be a survival tactic for individuals who live at the intersection of multiple marginalized identities marked by social instability and limited access to resources.…”

“…43,54,71 Recommendations for future HIV harm reduction programs include targeted advertising on Internet hook up sites and attention to the housing status of participants. 11,55 Housing status is particularly important because research demonstrates an unstable housing environment is associated with lower treatment adherence in HIV-positive transgender women. 11,37,38 A final recommendation is made by Bockting et al who argue that facilitating interaction between transgender peers in HIV prevention initiatives, in addition to promoting safer sex behaviors, deflects the impact of gender-based abuse and violence.…”