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- Title
Latent Constructs of Economic Marginality Associated with Sexual Behavior, Healthcare Access and HIV Outcomes Among Transgender and Nonbinary People in Three U.S. Cities.
- Authors
Paine, Emily Allen; Rivera-Cash, Dennis; Lopez, Jasmine M.; LeBlanc, Allen J.; Singh, Anneliese A.; Bockting, Walter O.
- Abstract
Transgender and nonbinary people (TNB) in the U.S. experience high HIV prevalence and diverse economic hardships. Yet a comprehensive understanding of how multiple, simultaneously occurring hardships—termed economic marginality—are together associated with healthcare and HIV outcomes is needed. Leveraging survey data from a sample of 330 TNB people in three U.S. cities, we conducted an exploratory mixed-source principal component analysis of latent factors of economic experience, then estimated their associations with sexual behavior, access to healthcare, HIV status, and HIV testing frequency. Two factors emerged: a traditional socioeconomic factor related to income, education, and employment (SES), and one related to housing precarity and (lack of) assets (Precarity). Higher Precarity scores were associated with sexual behavior, cost-based healthcare avoidance, discrimination-based healthcare avoidance, and more frequent HIV testing. Findings highlight the importance of understanding profiles of economic marginalization among trans and nonbinary people and can inform efforts to address upstream, structural factors shaping healthcare access and HIV outcomes in this key population.
- Subjects
UNITED States; DIAGNOSIS of HIV infections; AMERICAN transgender people; HEALTH services accessibility; MEDICAL care use; INCOME; RESEARCH funding; HUMAN sexuality; SOCIOECONOMIC factors; NONBINARY people; HIV infections; TREATMENT effectiveness; RESEARCH; FACTOR analysis; HOUSING; HEALTH equity; DISCRIMINATION (Sociology); PSYCHOSOCIAL factors; EDUCATIONAL attainment; EMPLOYMENT; MEDICAL care costs; EVALUATION
- Publication
AIDS & Behavior, 2024, Vol 28, Issue 4, p1197
- ISSN
1090-7165
- Publication type
Article
- DOI
10.1007/s10461-023-04143-8