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
. 2019 Oct;65(4):491-497.
doi: 10.1016/j.jadohealth.2019.04.032. Epub 2019 Jul 11.

Parent/Caregiver Responses to Gender Identity Associated With HIV-Related Sexual Risk Behavior Among Young Trans Women in San Francisco

Caitlin M Turner  1 , Jennifer Ahern  2 , Glenn-Milo Santos  3 , Sean Arayasirikul  4 , Erin C Wilson  4
Affiliations

Parent/Caregiver Responses to Gender Identity Associated With HIV-Related Sexual Risk Behavior Among Young Trans Women in San Francisco

Caitlin M Turner et al. J Adolesc Health. 2019 Oct.

Abstract

Purpose: Young trans women (YTW) carry a disproportionate burden of HIV. The developmental context of HIV risk for YTW is underexamined. The aim of this analysis was to examine whether parent/caregiver responses to gender identity were associated with engagement in HIV-related sexual risk behavior for YTW and whether these associations varied by racial/ethnic identity or age.

Methods: Baseline data from the SHINE study (n = 300) at San Francisco Department of Public Health (2012-2014) were analyzed. Multivariable Poisson binomial regression models characterized relationships between parent/caregiver responses to gender identity and HIV-related sexual risk behaviors, adjusting for select participant demographics. Statistically significant interactions (by race/ethnicity or age) were plotted using marginal predicted probabilities of sexual risk behaviors.

Results: Thirty-seven percent of YTW engaged in any condomless anal intercourse; 12% reported income from sex work in the last month. Ever moving away from family and friends because of gender identity was associated with condomless anal intercourse (adjusted prevalence ratio [PR] = 1.44, 95% confidence interval [CI] = 1.08-1.92, p = .01) and sex work (PR = 2.07, 95% CI = 1.14-3.75, p=.02). Ever receiving poor treatment from parents/caregivers because of gender identity was associated with sex work (PR = 3.47, 95% CI = 1.52-7.95, p < .01). Greater parent/caregiver acceptance of gender identity was associated with lower adjusted prevalence of condomless anal intercourse for Hispanic/Latinx YTW.

Conclusions: Negative parent/caregiver exposures related to YTW's gender identities were associated with increased HIV-related sexual risk behaviors, whereas parent/caregiver acceptance of gender identity was protective against condomless anal intercourse for Hispanic/Latinx YTW. There is a need for additional studies that inform interventions for YTW focusing on parent/caregiver relationships to prevent HIV-related risk behavior.

Keywords: HIV risk behavior; Intersectionality; Parents/caregivers; Sexual risk behavior; Young trans women.

PubMed Disclaimer

Conflict of interest statement

Declarations of competing interests: The authors declare that they have no competing interests.

Figures

Figure A1.
Figure A1.
Directed acyclic graph of the hypothesized relationship between parent/caregiver acceptance of gender identity and sexual risk behavior, SHINE Study, San Francisco, CA, 2012-2014 Note: Generated with the DAGitty tool [35]
Figure 1.
Figure 1.
Adjusted predicted probabilities of condomless anal intercourse for young trans women by parent/caregiver acceptance score and participant age, SHINE Study, San Francisco, CA, 2012-2014 Note: predicted probabilities were calculated for fixed covariate values (16 years of age, non-religious families, and HS/GED or less).
See this image and copyright information in PMC

References

    1. Grossman AH, D’Augelli AR. Transgender youth: invisible and vulnerable. J Homosex. 2006;51(1): 111–28. DOI: 10.1300/J082v51n01_06. - DOI - PubMed
    1. Flores AR, Herman J, Brown TN, et al. Age of individuals who identify as transgender in the United States. Williams Institute, UCLA School of Law; 2017.
    1. Wilson EC, Garofalo R, Harris RD, et al. Transgender female youth and sex work: HIV risk and a comparison of life factors related to engagement in sex work. AIDS Behav 2009;13(5):902–13. DOI: 10.1007/s10461-008-9508-8. - DOI - PMC - PubMed
    1. Garofalo R, Deleon J, Osmer E, et al. Overlooked, misunderstood and at-risk: exploring the lives and HIV risk of ethnic minority male-to-female transgender youth. J Adolesc Health. 2006;38(3):230–6. DOI: S1054-139X(05)00204-1. - PubMed
    1. Herbst JH, Jacobs ED, Finlayson TJ, et al. Estimating HIV prevalence and risk behaviors of transgender persons in the United States: a systematic review. AIDS Behav 2008;12(1):1–17. DOI: 10.1007/s10461-007-9299-3. - DOI - PubMed

Publication types