Sex trade in a male-to-female transgender population: psychosocial correlates of inconsistent condom use
Kristen Clements-Nolle A B D , Robert Guzman B and Susan G. Harris CA School of Public Health/274, University of Nevada, Reno, Nevada, NV 89557-0036, USA.
B San Francisco Department of Public Health, AIDS Office #500, 25 Van Ness Avenue, San Francisco, California, CA 94102, USA.
C Social Psychology Doctoral Program/300, University of Nevada, Reno, Nevada, NV 89557, USA.
D Corresponding author. Email: clements@unr.edu
Sexual Health 5(1) 49-54 https://doi.org/10.1071/SH07045
Submitted: 21 June 2007 Accepted: 30 October 2007 Published: 22 February 2008
Abstract
Background: Research suggests that because of economic necessity, many male-to-female (MTF) transgender individuals trade sex for money, drugs, housing, and other things they may need. To date, no studies have quantitatively assessed psychosocial correlates of condom use with this population. Methods: We conducted a cross sectional study with 190 MTF transgender individuals involved in sex trade in San Francisco, California. Multivariate logistic regression was used to determine factors independently associated with inconsistent condom use during receptive anal sex with exchange partners. Results: About one fifth of our participants reported inconsistent condom use during receptive anal sex in the past 6 months. In the multivariate model, low self-esteem [adjusted odds ratio (AOR) = 3.09; 95% confidence interval (CI) (1.28, 7.47)], a history of forced sex or rape [AOR = 2.91; 95% CI (1.06, 8.01)], and use of crack-cocaine [AOR = 2.59; 95% CI (1.09, 6.13)] were independently associated with inconsistent condom use. Conclusions: Our findings highlight an urgent need for multilevel risk reduction interventions for MTF transgender individuals involved in sex trade. Such interventions will be most effective if they address the psychosocial context of sexual risk taking by focusing on issues such as low self-esteem, sexual violence, and illicit drug use.
Acknowledgements
This study was supported by the Centers for Disease Control and Prevention, Cooperative Agreement U62CCU902017–12 and the State of California, Department of Health Services, Office of AIDS Grant 97–10787. The views expressed in this article are those of the authors, not necessarily the funding agencies. We want to express our gratitude to our participants. We would also like to thank Ari Bachrach, Nikki Calma, Carla Clynes, Nashanta Stanley, Matt Rice, and Doan Thai for conducting data collection, counselling, testing, and referrals; Vince Guilin and Scott Ikeda for field coordination; Art DeGuzman, Stella Cheung, Irene Lee and Belinda Van, for data entry and management.
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