Recent studies have detected alarming levels of HIV and other STDs in a unique population: biological males who define themselves as females (termed here as trans women). The proposed study by a new investigator affiliated with the National Development and Research Institutes (NDRI) represents a major epidemiological initiative designed to identify and elucidate behavioral and social risk factors for HIV/STDs in this unique group. Using multiple sampling techniques, 550 trans women between the ages of 19 and 39 will be recruited in the New York City Metropolitan Area and tested for HIV, chlamydia, gonorrhea, syphilis and hepatitis B and C. HIV negative subjects will be followed for three years to determine changes in their risk factors, and HIV/ STD infection/reinfection. The prevalence and yearly incidence of HIV in this population will be determined. In conjunction with the cohort research design, using generalized estimating equations (GEE) and other techniques, suggested risk factors for HIV/STDs among trans women will be systematically tested. Aspects of injection drug use (for psychoactive drugs and female hormones) and high-risk sexual behavior (HRSB) will be evaluated as behavioral modes of HIV/STD transmission. Hypothesized associations among economic hardships (e.g. unemployment) and HIV/STDs are expected to be mediated by HRSB with paying sexual partners (sex work). This reflects the notion of """"""""survival sex,"""""""" where trans women engage in sex work out of financial necessity. Hypothesized associations among gender identity conflict and HIV/STDs are also expected to be mediated HRSB. This reflects the notion of """"""""validation sex,"""""""" where trans women seek out sexual relationships in an attempt to legitimate a sense of themselves as females, which is otherwise denied to them. The knowledge about HIV/STD etiology that emerges from this study will directly inform future interventions and prevention aimed at this population.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA018080-05
Application #
7455964
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Jones, Dionne
Project Start
2004-08-01
Project End
2009-12-31
Budget Start
2008-07-01
Budget End
2009-12-31
Support Year
5
Fiscal Year
2008
Total Cost
$537,693
Indirect Cost
Name
National Development & Research Institutes
Department
Type
DUNS #
080481880
City
New York
State
NY
Country
United States
Zip Code
10010
Nuttbrock, Larry A; Hwahng, Sel J (2017) Ethnicity, Sex Work, and Incident HIV/STI Among Transgender Women in New York City: A Three Year Prospective Study. AIDS Behav 21:3328-3335
Nuttbrock, Larry; Bockting, Walter; Rosenblum, Andrew et al. (2015) Gender Abuse and Incident HIV/STI Among Transgender Women in New York City: Buffering Effect of Involvement in a Transgender Community. AIDS Behav 19:1446-53
Nuttbrock, Larry; Bockting, Walter; Rosenblum, Andrew et al. (2014) Gender abuse, depressive symptoms, and substance use among transgender women: a 3-year prospective study. Am J Public Health 104:2199-206
Nuttbrock, Larry; Bockting, Walter; Rosenblum, Andrew et al. (2014) Gender abuse and major depression among transgender women: a prospective study of vulnerability and resilience. Am J Public Health 104:2191-8
Hwahng, Sel J; Nuttbrock, Larry (2014) Adolescent gender-related abuse, androphilia, and HIV risk among transfeminine people of color in New York City. J Homosex 61:691-713
Nuttbrock, Larry; Bockting, Walter; Rosenblum, Andrew et al. (2013) Gender abuse, depressive symptoms, and HIV and other sexually transmitted infections among male-to-female transgender persons: a three-year prospective study. Am J Public Health 103:300-7
Nuttbrock, Larry A (2012) Culturally competent substance abuse treatment with transgender persons. J Addict Dis 31:236-41
Nuttbrock, Larry; Bockting, Walter; Mason, Mona et al. (2011) A further assessment of Blanchard's typology of homosexual versus non-homosexual or autogynephilic gender dysphoria. Arch Sex Behav 40:247-57
Nuttbrock, Larry; Bockting, Walter; Rosenblum, Andrew et al. (2010) The limitations of Blanchard's typology: a response to Lawrence (2010). Arch Sex Behav 39:1017-20
Nuttbrock, Larry; Hwahng, Sel; Bockting, Walter et al. (2010) Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. J Sex Res 47:12-23

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