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Housing Status and HIV Risk Behaviors Among Transgender Women in Los Angeles

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Abstract

Due to social stigma, lack of social support, and minimal legal employment opportunities, transgender women (transwomen) face elevated rates of unstable housing. This study examined the association between housing status and HIV risk behaviors among 517 transwomen encountered through street outreach. Seven variables (including sociodemographics, HIV status, housing status, and sexual partner type) were used to estimate partial associations during multivariable analyses; housing status was coded trichotomously (housed, marginally housed, and homeless) for these analyses. Results demonstrated that homeless and marginally housed transwomen engaged in significantly higher rates of illicit drug use than housed transwomen; however, marginally housed and housed transwomen engaged in significantly higher rates of illegal hormone injections than homeless transwomen. Rates of sex work were high in the sample as a whole, though sex with an exchange partner was most common among the marginally housed transwomen. Multivariate logistic regression revealed that unstable housing moderated the association between HIV status and engagement in unprotected serodiscordant anal intercourse. The marginally housed transwomen exhibited the greatest risk profile for HIV acquisition or transmission.

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Acknowledgments

This study was supported by the Los Angeles County, Department of Public Health, Division of HIV and STD Programs (formerly Office of AIDS Programs and Policy) contract #H700861 and #PH-001039. Dr. Reback acknowledges additional support from the National Institute of Mental Health (P30 MH58107).

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Authors and Affiliations

  1. Friends Research Institute, Inc, 1419 N. La Brea Ave, Los Angeles, CA, 90028, USA

    Jesse B. Fletcher, Kimberly A. Kisler & Cathy J. Reback

  2. UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA

    Cathy J. Reback

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  1. Jesse B. Fletcher
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  2. Kimberly A. Kisler
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  3. Cathy J. Reback
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Correspondence to Jesse B. Fletcher.

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Fletcher, J.B., Kisler, K.A. & Reback, C.J. Housing Status and HIV Risk Behaviors Among Transgender Women in Los Angeles. Arch Sex Behav 43, 1651–1661 (2014). https://doi.org/10.1007/s10508-014-0368-1

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