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Partnership-level correlates of sexual risk taking within the sexual partnerships of young transwomen in San Francisco, California
  1. Maximo Robert Prescott1,2,
  2. Glenn-Milo Santos1,3,
  3. Sean Arayasirikul1,4,
  4. Erin Wilson1,5
  1. 1 Center for Public Health Research, San Francisco Department of Public Health, San Francisco, California, USA
  2. 2 School of Public Health, University of California Berkeley, Berkeley, California, USA
  3. 3 Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
  4. 4 Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
  5. 5 Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
  1. Correspondence to Maximo Robert Prescott, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA 94102, USA; maximo{at}


Objectives Little is known about the sexual networks of young transwomen, leaving a major gap in what we know about transmission dynamics and the elevated rates of HIV in this population. The objective of this study was to understand partnership-level factors associated with condomless anal sex among young transwomen.

Methods A secondary data analysis of the sexual partnerships of young transwomen was conducted using baseline data from the SHINE study. Generalised estimating equation logistic regressions were used to assess for partnership-level associations between partnership type, age, injection drug use and racial concordance, HIV seroconcordance, sexual role and condomless receptive (CRAI) and insertive anal intercourse (CIAI).

Results Our analysis included 187 young transwomen that reported a total of 464 sexual partnerships where they had at least one episode of anal sex in the past 6 months. We found casual (n=232 or 50%) and commercial partnerships (n=106 or 22.8%) to be significantly associated with a lower odds of CIAI (OR=0.53, 95% CI 0.32 to 0.86 and OR=0.39, 95% CI 0.18 to 0.82) and CRAI (OR=0.30, 95% CI 0.19 to 0.47 and OR=0.35, 95% CI 0.2 to 0.62) compared with main partnerships (n=126 or 27.2%). Additionally, HIV-positive seroconcordant (n=25 or 5.4%, OR=4.05, 95% CI 1.44 to 11.40) and injection-drug using partnerships (n=25 or 5.4%, OR=3.66, 95% CI 1.34 to 9.95) were found to be significantly associated with an increased odds of CIAI among participants compared with HIV-negative seroconcordant (n=330 or 71.1%) and non-using partnerships (n=338 or 72.8%), respectively.

Conclusion Young transwomen, like other populations, engage in condomless sex more often with main than casual and commercial partners, suggesting a need for interventions that address sexual practices with steady main partners.

  • HIV
  • sexual networks
  • sexual behaviour
  • epidemiology (general)

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  • Handling editor Jackie A Cassell

  • Contributors MRP, EW and G-MS collaborated in the writing of the manuscript. EW and SA were involved in the design and conducting of the study. MRP and EW collaborated on the main directions for data analysis and interpretation of its results. MRP performed the statistical analyses. MRP, EW, G-MS and SA revised the manuscript before submission.

  • Funding This study received funding from the National Institute of Mental Health (NIHM), Bethesda, Maryland.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.