Situated Vulnerabilities, Sexual Risk, and Sexually Transmitted Infections' Diagnoses in a Sample of Transgender Youth in the United States

TitleSituated Vulnerabilities, Sexual Risk, and Sexually Transmitted Infections' Diagnoses in a Sample of Transgender Youth in the United States
Publication TypePublication
Year of Publication2019
AuthorsReisner SL, Jadwin-Cakmak L, Sava L, Liu SS, Harper GW
JournalAIDS Patient Care STDS
Volume33
Issue3
Pagination120-130
Date Published2019 Mar
ISSN1557-7449
Abstract

In the United States, sexually transmitted infections (STIs) confer significant morbidity in adolescents and young adults. STIs are not well characterized in transgender and other gender minority youth (TGMY) who have a gender identity that differs from the sex assigned to them at birth. This study sought to fill this gap. In 2015-2016, the Adolescent Medicine Trials Network for HIV/AIDS Interventions conducted Protocol 130, Affirming Voices for Action, enrolling a diverse sample of TGMY 16-24 years of age from 14 US geographic locations. Multivariable analyses regressed lifetime STI diagnosis on "situated vulnerabilities" (demographics, social/economic issues, mental/behavioral health conditions, and health care experience). Approximately one-third were living with HIV infection (31%); 33% had a history of one or more STIs, excluding HIV. The most frequently diagnosed STIs were 55% chlamydia, 48% syphilis, and 47% gonorrhea. The odds of STI was 4.06 times higher for trans feminine youth assigned a male sex at birth compared to trans masculine youth assigned a female sex at birth (p = 0.03). Additional risk factors for lifetime STI were as follows: nonbinary gender identity (p = 0.004), medical gender affirmation (p = 0.03), and transactional sex (p = 0.01). Nearly one-third (31%) reported condomless vaginal and/or anal sex in the last 6 months, suggesting a need for ongoing STI prevention, screening, diagnosis, and treatment. TGMY are a vulnerable group to STIs in need of public health attention. Clinical care for STIs will benefit from considering risk factors facing youth in general (e.g., sex work), alongside those vulnerabilities unique to TGMY (e.g., medical gender affirmation).

DOI10.1089/apc.2018.0249
Alternate JournalAIDS Patient Care STDS
PubMed ID30844303
PubMed Central IDPMC6442265
Grant ListU01 HD040474 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States