Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec 26;3(1):210-219.
doi: 10.1089/trgh.2018.0032. eCollection 2018.

Day-Level Associations Between Substance Use and HIV Risk Behavior Among a Diverse Sample of Transgender Women

Brett M Millar  1 , Devin English  1 , Raymond L Moody  1   2 , H Jonathon Rendina  1   2   3 , Demetria Cain  1   4 , Nadav Antebi-Gruszka  1   5 , Joseph A Carter  1   2 , Jeffrey T Parsons  1   2   3
Affiliations

Day-Level Associations Between Substance Use and HIV Risk Behavior Among a Diverse Sample of Transgender Women

Brett M Millar et al. Transgend Health. .

Abstract

Purpose: Transgender women in the United States face elevated rates of HIV and of substance use. Studies measuring overall or aggregate levels of substance use have linked use to increased HIV transmission risk behavior (TRB). Although intensive longitudinal studies in other populations have found day-level links between substance use and TRB, no study has yet explored such links among transgender women. This study aimed to fill this gap in the literature. Methods: Utilizing survey and 60-day timeline follow-back interview data from a sample of 214 transgender women in New York City, we tested whether day-level heavy drinking, marijuana use, and/or nonprescription stimulant use were associated with odds of engaging in any sex (vs. no sexual activity) or engaging in TRB (vs. sex without TRB), adjusting for overall levels of use. Results: Multilevel models showed that each of the three substance types was associated with greater odds of engaging in sex on a given day-and more strongly so for heavy drinking among those with higher rates of heavy drinking, and for stimulant use among those with lower rates of stimulant use. Only marijuana use was associated with greater odds of TRB on a given day, but only among those with higher rates of use. Conclusion: These findings substantiate day-level links between substance use and engaging in sexual activity among transgender women, and importantly, between marijuana use and greater likelihood of TRB on a day when sexual activity occurs. This highlights the importance of addressing substance use for sexual health among transgender women especially focusing on marijuana use.

Keywords: alcohol; drug use; harm reduction; intensive longitudinal data; prevention.

PubMed Disclaimer

Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Marginal probabilities of engaging in sexual activity based on individual and day-level use of substances. Note: Low substance use and high substance use are defined at the 25th and 75th percentiles, respectively.
<b>FIG. 2.</b>
FIG. 2.
Marginal probabilities of engaging in sexual TRB based on individual-level and day-level use of substances. Note: Low substance use and high substance use are defined at the 25th and 75th percentiles, respectively. TRB, transmission risk behavior.
See this image and copyright information in PMC

References

    1. Wanta JW, Unger CA. Review of the transgender literature: where do we go from here?. Transgend Health. 2017;2:119–128 - PMC - PubMed
    1. Baral SD, Poteat T, Strömdahl S, et al. . Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13:214–222 - PubMed
    1. Centers for Disease Control and Prevention. HIV among transgender people. Available at www.cdc.gov/hiv/group/gender/transgender Accessed 3August, 2017
    1. Grant JM, Mottet LA, Tanis J, et al. . Injustice at every turn: a report of the national transgender discrimination survey. Washington DC: The National Gay and Lesbian Task Force and the National Center for Transgender Equality; 2011. Available at www.thetaskforce.org/injustice-every-turn-report-national-transgender-di... Accessed November1, 2018
    1. Nadal KL, Davidoff KC, Fujii-Doe W. Transgender women and the sex work industry: roots in systemic, institutional, and interpersonal discrimination. J Trauma Dissociation. 2014;15:169–183 - PubMed

LinkOut - more resources