Evaluation of a sexual health approach to reducing HIV/STD risk in the transgender community

Abstract

Despite reports of high prevalence of human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) among the transgender community, very little prevention education has targeted this population. To fill this gap, we developed and evaluated a transgender-specific intervention, All Gender Health, which incorporates prevention strategies into comprehensive sexuality education. Transgender participants (N=181) attended the two-day seminar in community-based venues. The curriculum was delivered via lectures, panel discussions, videos, music, exercises and small group discussions. Attitudes toward condom use, safer sex self-efficacy and sexual risk behaviour were evaluated before participation in the intervention (pre-test), immediately after participation (post-test) and at three-month follow-up. Compared to pre-test values, significant improvements were seen in attitudes toward condom use and in safer sex self-efficacy at post-test, and in attitudes toward condom use, increased monogamy and decreased sexual risk behaviour at three-month follow-up. Pre-test data identified unprotected anal, vaginal and oral sex as the most commonly reported risk behaviours. Many respondents also indicated problems with social discrimination, depression, suicidal ideation and sexual functioning. Future interventions should address these risk co-factors. Alternative interventions need to be developed to target those who, as a result of social marginalization, are less likely to be reached with an intensive seminar-based intervention.

Acknowledgments

This project was a collaborative effort between the University of Minnesota Program in Human Sexuality and the following transgender community organizations: Beta-Gamma and Tau Epsilon Tri-Ess, City of Lakes Crossgender Community, Imperial Sovereign Court of the Ice Castle, Midwest Trans Institute and the Minnesota Boyz. The authors thank the seminar staff and the transgender community advisory board for their dedicated service, and are grateful to Anne Marie Weber-Main, PhD, and Mary Beth Nierengarten, MA, for their editorial suggestions and critical review of earlier manuscript drafts.

This study was funded by grants from the Minnesota Department of Health, H12-1769 (Walter Bockting, Principal Investigator), H12-16948 (Walter Bockting, Principal Investigator) and H12-2453 (Bean Robinson, Principal Investigator).