Environmental, psychosocial, and individual correlates of HIV risk in ethnic minority male-to-female transgender youth

Although HIV risk in male-to-female (MTF) transgender adults is well documented, limited data exists on the experiences of MTF transgender youth. This cross-sectional study examines environmental, psychosocial, and individual correlates of risky sex among 51 MTF ethnic minority transgender youth age 16-25. Fifty-nine percent of participants reported high-risk sex defined as either unprotected insertive or receptive anal intercourse in the past year. Multiple factors that included higher depression scores, lower self-esteem, less social support, poorer safer sex communication skills, being non-African American, use of injection silicone, history of arrest, history of forced sex and having sex while high on drugs/alcohol, were significantly associated with high-risk sex among participants. Multivariate logistic regression indicated that among possible models with two independent variables, poorer communication skills and non-African American race/ethnicity were the most significant predictors of high-risk sex. Future studies examining HIV risk mechanisms in MTF transgender youth are needed.