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Sex Transm Infect. 2019 Jan 25. pii: sextrans-2018-053609. doi: 10.1136/sextrans-2018-053609. [Epub ahead of print]

Partnership-level correlates of sexual risk taking within the sexual partnerships of young transwomen in San Francisco, California.

Author information

1
Center for Public Health Research, San Francisco Department of Public Health, San Francisco, California, USA maximo@berkeley.edu.
2
School of Public Health, University of California Berkeley, Berkeley, California, USA.
3
Center for Public Health Research, San Francisco Department of Public Health, San Francisco, California, USA.
4
Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA.
5
Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA.
6
Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.

Abstract

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.

KEYWORDS:

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

Conflict of interest statement

Competing interests: None declared.

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