Abstract
Background: Little research has evaluated the social and sexual network-related health outcomes of young black transgender women (TGW) or compared these outcomes with those of black men who have sex with men (MSM). Social network analysis offers one potent means of understanding the dynamics driving the broad spectrum of adverse outcomes experienced by these subgroups.Methods: We examined the social and sexual health network traits of 618 black individuals assigned male at birth who have sex with men, 47 (7.6%) of whom identified as TGW. Using respondent-driven sampling, data collection occurred over three waves between 2013 and 2016, in Chicago, Illinois. Univariate, logistic regression, and confidant and sexual network analyses were conducted to characterize dynamic network features.Results: TGW's mean age was 22.1 (standard deviation ±2.6). TGW's sexual networks were significantly less stable (stability ratio of 0.175 vs. 0.278 among MSM, p=0.03) and had greater network turnover (turnover ratio of 0.825 vs. 0.735, p=0.04). TGW also had significantly more sex partners (7.6 vs. 4.0, p=0.0002) and exchange sex (odds ratio=2.97; 95% confidence interval: 1.66–5.32, p<0.001), lower rates of employment (39.6% vs. 71.1%, p<0.001), and more reported an income <$20,000 (93.5% vs. 80.8%, p=0.029). Within confidant networks, TGW had a borderline significantly higher network turnover ratio (0.703 vs. 0.625, p=0.06). Furthermore, both TGW and MSM had high, but similar, HIV rates (42.3% vs. 30.6%, respectively; p=0.17). There were no significant structural network differences vis-à-vis mean degree (p=0.46), betweenness centrality (p=0.40), closeness centrality (p=0.18), or average shortest path length (borderline statistically significant at p=0.06).Conclusion: Using data from a representative sample of younger black individuals, we observed black TGW have less sexual network stability in contrast to black MSM but comparable structural network features. We further observed that both groups, and black TGW especially, possess considerable system-level, socioeconomic, and sexual health burdens.
Highlights
Recent analysis suggests that the current population of transgender individuals in the United States, persons whose gender identity differs from the sex which they were assigned at birth, numbers roughly 1 million,[1] with changing definitions and greater acceptance for nonheteronormativity portending substantial increases in transgender population size estimates in coming years.[2]
Characteristics of black transgender women (TGW) A final sample of 618 individuals at Wave 1 was included in the analysis
Our results illustrated that black TGW’s sexual networks change significantly more than black men who have sex with men (MSM)’s and are generally less stable. These dynamics are especially critical given the observed association between belongingness, well-being, and sexual health in the transgender population.[55,56,57]
Summary
Recent analysis suggests that the current population of transgender individuals in the United States, persons whose gender identity differs from the sex which they were assigned at birth, numbers roughly 1 million,[1] with changing definitions and greater acceptance for nonheteronormativity portending substantial increases in transgender population size estimates in coming years.[2]. Little research has evaluated the social and sexual network-related health outcomes of young black transgender women (TGW) or compared these outcomes with those of black men who have sex with men (MSM). Methods: We examined the social and sexual health network traits of 618 black individuals assigned male at birth who have sex with men, 47 (7.6%) of whom identified as TGW. TGW had a borderline significantly higher network turnover ratio (0.703 vs 0.625, p = 0.06). Both TGW and MSM had high, but similar, HIV rates (42.3% vs 30.6%, respectively; p = 0.17). Conclusion: Using data from a representative sample of younger black individuals, we observed black TGW have less sexual network stability in contrast to black MSM but comparable structural network features. We further observed that both groups, and black TGW especially, possess considerable system-level, socioeconomic, and sexual health burdens
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