Condom-Protected Sex and Minority Stress: Associations with Condom Negotiation Self-Efficacy, "Passing" Concerns, and Experiences with Misgendering among Transgender Men and Women in Brazil.

Ramiro Figueiredo Catelan,Daniel Augusto Mori Gagliotti,Angelo Brandelli Costa,Maria Inês Rodrigues Lobato,Alexandre Saadeh

doi:10.3390/ijerph18094850

Abstract

This cross-sectional exploratory study aims to verify associations between condom-protected sex, condom negotiation self-efficacy, self-esteem, and four minority stressors (experiences with misgendering, “passing” concerns, anticipated prejudice, and perceived prejudice) among transgender men (TM) and transgender women (TW). 260 individuals (192 TW and 68 TM) residing in two Brazilian states participated in the study. Data was collected online and in two hospital programs for transgender people and included sociodemographic data, condom-protected sex, the Trans-Specific Condom/Barrier Negotiation Self-Efficacy (T-Barrier) Scale, the Rosenberg Self-Esteem Scale, and four minority stressors. Measures that were significantly associated with condom-protected sex were tested as independent variables in a linear regression model. The main results suggest that lower condom negotiation self-efficacy, higher “passing” concerns, and higher experiences with misgendering were predictors of lower frequency of condom-protected sex. These negative outcomes were found among both TM and TW, which justifies their inclusion in public health policies. Structural strategies and clinical interventions are suggested to address condom negotiation self-efficacy and “passing” concerns in transgender populations.

Highlights

The literature shows that Condom-protected sex (CPS) and condom negotiation self-efficacy (CNSE) are associated with consistency/regularity of use and act as protectors against HIV and other sexually transmitted infections (STIs) in the cisgender population, that is, people whose gender identity is aligned with the sex designated at birth [1,2,3,4,5]
Our study complements the literature of the field and innovates, mainly because it demonstrates the impact of condom negotiation self-efficacy on condom use, and suggests macro and micro-interventions address the topic
Non-binary people were not included in the sample, which fails to include the important diversity present in transgender communities

Summary

Introduction

Introduction iationsCondom-protected sex (CPS) refers to individual’s consistent use of condoms during sexual intercourse, while condom negotiation self-efficacy (CNSE) refers to the confidence to assertively ensure condom use during sexual intercourse, preventing unwanted non-use.The literature shows that CPS and CNSE are associated with consistency/regularity of use and act as protectors against HIV and other sexually transmitted infections (STIs) in the cisgender population, that is, people whose gender identity is aligned with the sex designated at birth [1,2,3,4,5].Sexual coercion, abusive relationships and exposure to intimate partner violence are some of the factors associated with unprotected sex without condoms and decreasedCNSE capacity with sexual partners. Condom-protected sex (CPS) refers to individual’s consistent use of condoms during sexual intercourse, while condom negotiation self-efficacy (CNSE) refers to the confidence to assertively ensure condom use during sexual intercourse, preventing unwanted non-use. The literature shows that CPS and CNSE are associated with consistency/regularity of use and act as protectors against HIV and other sexually transmitted infections (STIs) in the cisgender population, that is, people whose gender identity is aligned with the sex designated at birth [1,2,3,4,5]. These experiences have been widely investigated in cisgender people, cisgender women [6,7,8,9].

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Conclusion