Men Who Have Sex with Transgender Women: Challenges to Category-based HIV Prevention

Department of Social Policy and Social Work, University of Oxford, 32 Wellington Square, Oxford, OX1 2ER, UK.
AIDS and Behavior (Impact Factor: 3.49). 02/2008; 12(1):18-26. DOI: 10.1007/s10461-007-9303-y
Source: PubMed


Although transgender women are acknowledged as a priority population for HIV prevention, there is little knowledge on men who have sex with transgender women (MSTGWs). MSTGWs challenge conventional sexual orientation categories in public health and HIV prevention research, and warrant increased attention from the public health community. This paper used qualitative techniques to analyze how MSTGWs describe their sexual orientation identities, and to explore the correspondence between men's identities and sexual behaviors with transgender women. We conducted in-depth semi-structured individual interviews with 46 MSTGWs in San Francisco. We observed a diversity in the ways participants identified and explained their sexual orientation, and found no consistent patterns between how men described their sexual orientation identity versus their sexual behavior and attraction to transgender women. Findings from this qualitative study question the utility of category-based approaches to HIV prevention with MSTGWs and offer insights into developing HIV interventions for these men.

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    • "White, Western academics acknowledged the problems of MSM categorizations and how or if transgender people fit or do not fit into MSM (, 2002; Operario et al., 2008; UNAIDS, n.d.), critique from (mainly non-Western) people of colour articulated the complexities of sex and gender within MSM. Khan (2000, p. 14) argues that South Asian cultures have incredible diversity of identities, desires, and frameworks of expression – a true queer space. "
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    ABSTRACT: The term ‘men who have sex with men’ (MSM) as commonly used by HIV/AIDS researchers and policy makers is said to describe an obvious group of men. Or does it? While MSM disrupts the homosexual/heterosexual dichotomy through focusing on sexual practices rather than sexual identity, it remains entrenched in binary understandings of sex and gender. Influenced by queer and trans theories, a genderqueer methodology is employed to examine what discourses are deployed when MSM are categorized as a seemingly homogenous group. Who are the “men” in MSM and what are the material consequences of MSM discourse in HIV/AIDS work? Guided by feminist poststructural and Foucauldian theories, this study highlights how MSM discourse functions to exclude trans, intersex, and other non-normative sexed and gendered people while considering the potentially deadly effects of this discourse on those outside of MSM categorizations particularly focusing on its use in the Canadian Guidelines on STIs.
    03/2010, Degree: Master of Social Work, Supervisor: Susan Strega
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    ABSTRACT: African American men who have sex with men and women (MSMW), but who do not form a sexual identity around same-sex behavior, may experience risk for HIV infection and transmission. This paper reports cross-sectional survey findings on sexual behaviors and substance use of urban non-gay- or non-bisexual-identified African American MSMW (n = 68), who completed behavior assessment surveys using audio-computer assisted self-interviewing technology. Overall, 17.6% reported being HIV-positive. In the past 3 months, 70.6% had unprotected insertive sex with a female, 51.5% had unprotected insertive anal sex (UIAS) with a male, 33.8% had unprotected receptive anal sex (URAS) with a male, 25% had UIAS with a transgender female, and 10.3% had URAS with a transgender female. Findings indicated a bridging potential for HIV and sexually transmitted infections across groups, such that 38.2% reported concurrent unprotected sex with female and male partners and 17.6% reported concurrent unprotected sex with female and transgender female partners. In the past 3 months, 70.6% used alcohol before sex and 85% used drugs before sex. Men who used drugs before sex had a tenfold increased likelihood for unprotected sex with male partners, and men who injected drugs had a nearly fivefold increased likelihood for unprotected sex with a transgender female. Interventions to address sexual risk behaviors, especially partner concurrency, and substance use behavior for these men are warranted.
    AIDS and Behavior 08/2009; 15(3):576-83. DOI:10.1007/s10461-009-9588-0 · 3.49 Impact Factor
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