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- Title
Gender Abuse, Depressive Symptoms, and HIV and Other Sexually Transmitted Infections Among Male-to-Female Transgender Persons: A Three-Year Prospective Study.
- Authors
Nuttbrock, Larry; Bockting, Walter; Rosenblum, Andrew; Hwahng, Sel; Mason, Mona; Macri, Monica; Becker, Jeffrey
- Abstract
Objectives. We examined gender abuse and depressive symptoms as risk factors for HIV and other sexually transmitted infections (HIV/STI) among male-to-female transgender persons (MTFs). Methods. We conducted a 3-year prospective study of factors associated with incident HIV, syphilis, hepatitis B, chlamydia, and gonorrhea among 230 MTFs from the New York Metropolitan Area. Statistical techniques included Cox proportional hazards analysis with time varying covariates. Results. Among younger MTFs (aged 19-30 years), gender abuse predicted depressive symptoms (Center for Epidemiologic Studies Depression score ‡ 20), and gender abuse combined with depressive symptoms predicted both high-risk sexual behavior (unprotected receptive anal intercourse) and incident HIV/STI. These associations were independent of socioeconomic status, ethnicity, sexual orientation, hormone therapy, and sexual reassignment surgery. Conclusions. Gender abuse is a fundamental distal risk factor for HIV/STI among younger MTFs. Interventions for younger MTFs are needed to reduce the psychological impact of gender abuse and limit the effects of this abuse on high-risk sexual behavior. Age differences in the impact of gender abuse on HIV/STI suggest the efficacy of peer-based interventions in which older MTFs teach their younger counterparts how to cope with this abuse.
- Subjects
NEW York (State); HIV infection risk factors; SEXUALLY transmitted disease risk factors; AGE distribution; CONFIDENCE intervals; STATISTICAL correlation; MENTAL depression; INTERVIEWING; LONGITUDINAL method; PSYCHOLOGICAL tests; STATISTICAL sampling; SCALES (Weighing instruments); SEX crimes; SEXUALLY transmitted diseases; AFFINITY groups; TRANSGENDER people; UNSAFE sex; PREDICTIVE validity; DISEASE incidence; PROPORTIONAL hazards models; RETROSPECTIVE studies; DESCRIPTIVE statistics
- Publication
American Journal of Public Health, 2013, Vol 103, Issue 2, p300
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2011.300568