Characteristics of male HIV-positive Ryan White clients with transgender sexual partners

Background: Data on HIV-positive men who have sex with transgender persons (MST) are sparse. Sexual histories obtained from HIV-positive men in New York City (NYC) provide a unique opportunity to characterize MST, as compared to other HIV-positive men.

Methods: Ryan White Part A providers assess clients on demographic, behavioral, and clinical characteristics, including sexual history, via standardized interview. Male HIV-positive clients were included in this analysis if they were assessed from 1/1/11-6/30/13, reported sexual activity during the year before assessment, and matched to the NYC HIV Surveillance Registry. Group assignment was hierarchical as follows: those reporting transgender partners were categorized as MST; men reporting male partners were categorized as men who have sex with men (MSM); and those reporting only female partners were categorized as men who have sex with women (MSW). Analyses included descriptive frequencies on MST and Chi-square tests identifying associations between each characteristic and MST group membership.

Results: Of 147 MST, almost 20% were foreign-born, 42% were unstably housed, 31% had a history of incarceration, and 70% lived below federal poverty level (FPL). MST were significantly more likely than MSW (n=2189) to have recent IDU, unprotected sex, multiple sex partners and interrupted care. MST were significantly more likely than MSM (n=2306) to be: aged 50 or older, without a high school diploma, unemployed, below FPL, and previously incarcerated.

Conclusions: MST exhibited elevated risk of onward HIV transmission and a greater burden of life and environmental stressors. These results can inform HIV prevention and care interventions for MST.