Our long-range goal is to reduce HIV infection and transmission among communities most at risk by (1) identifying gender-specific factors underlying the psychosocial context in which HIV risk occurs and (2) applying these findings to the development of innovative models for effective, targeted prevention interventions. For all populations, HIV risk-especially as manifested in sexual behaviors-intersects with people's gendered norms, expectations, and behaviors. This is particularly so, however, for members of the transgender community. Due to challenges with their gender identity, transgendered individuals have a heightened awareness of how gender attributions and expectations affect sexual behavior. This application will examine transgender people's experiences in both the male and female gender role to understand how gender structures HIV risk. The objective of this particular application is to qualitatively and quantitatively assess the relationship between specific gendered contextual factors and HIV risk in a transgender sample, thereby providing the basis for the development of a future intervention model for addressing gender-related prevention challenges of different at-risk populations. We will pursue the following three specific aims: (1) Qualitatively examine transgender people's experiences of how gender influences HIV risk; (2) Assess the empirical relationship between gender identity, social sex role, and HIV risk in a transgender sample; and (3) Determine the impact of gender-related stigma, shame, and affirmation and disclosure of identity on HIV risk and protective behaviors. Our cross-sectional study will employ a combination of Internet-based qualitative and quantitative methodologies to engage a national sample of transgendered individuals in semi-structured, in-depth online interviews (N=60) and an online survey (N=600). This study is expected to yield the following outcomes. First, it will increase our understanding of how gendered norms, expectations, and behaviors influence HIV risk, and importantly, which constructs deserve immediate testing in clinical settings and intervention programs. Second, tests for associations between gender-related constructs (crossgender identification and presentation, social sex role conformity, type of transgender identity, gender-related stigma, internalized transphobia, and affirmation of gender identity) and HIV risk will provide new means of identifying individuals at higher risk for HIV and with high likelihood of benefiting from targeted interventions focused on the underlying gender-based influences on their risky sexual behaviors. Notably, while this work is expected to directly benefit transgender individuals and their partners (who have been largely neglected in HIV prevention efforts), it will also provide an empirical basis (or additional hypotheses, research, and an intervention model targeting gender as a contextual HIV risk factor among other populations.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA015269-02
Application #
6523579
Study Section
Special Emphasis Panel (ZRG1-AARR-7 (50))
Program Officer
Jones, Dionne
Project Start
2001-09-30
Project End
2004-08-31
Budget Start
2002-09-01
Budget End
2003-08-31
Support Year
2
Fiscal Year
2002
Total Cost
$327,232
Indirect Cost
Name
University of Minnesota Twin Cities
Department
Family Medicine
Type
Schools of Medicine
DUNS #
168559177
City
Minneapolis
State
MN
Country
United States
Zip Code
55455
Jackman, Kasey B; Dolezal, Curtis; Bockting, Walter O (2018) Generational Differences in Internalized Transnegativity and Psychological Distress Among Feminine Spectrum Transgender People. LGBT Health 5:54-60
Gonzalez, Cesar A; Gallego, Joseph D; Bockting, Walter O (2017) Demographic Characteristics, Components of Sexuality and Gender, and Minority Stress and Their Associations to Excessive Alcohol, Cannabis, and Illicit (Noncannabis) Drug Use Among a Large Sample of Transgender People in the United States. J Prim Prev 38:419-445
Perez-Brumer, Amaya; Hatzenbuehler, Mark L; Oldenburg, Catherine E et al. (2015) Individual- and Structural-Level Risk Factors for Suicide Attempts Among Transgender Adults. Behav Med 41:164-71
Horvath, Keith J; Iantaffi, Alex; Swinburne-Romine, Rebecca et al. (2014) A comparison of mental health, substance use, and sexual risk behaviors between rural and non-rural transgender persons. J Homosex 61:1117-30
Feldman, Jamie; Romine, Rebecca Swinburne; Bockting, Walter O (2014) HIV risk behaviors in the U.S. transgender population: prevalence and predictors in a large internet sample. J Homosex 61:1558-88
Bockting, Walter O; Miner, Michael H; Swinburne Romine, Rebecca E et al. (2013) Stigma, mental health, and resilience in an online sample of the US transgender population. Am J Public Health 103:943-51
Miner, Michael H; Bockting, Walter O; Romine, Rebecca Swinburne et al. (2012) Conducting Internet Research With the Transgender Population: Reaching Broad Samples and Collecting Valid Data. Soc Sci Comput Rev 30:202-211
Iantaffi, Alex; Bockting, Walter O (2011) Views from both sides of the bridge? Gender, sexual legitimacy and transgender people's experiences of relationships. Cult Health Sex 13:355-70