The conflation of gender and sex: Gaps and opportunities in HIV data among transgender women and MSM

ABSTRACT

Historically, HIV studies have conflated men who have sex with men (MSM) with transgender (trans) women, explicitly excluded trans individuals, or included sample sizes of trans people that are too small to reach meaningful conclusions. Despite the heavy burden of HIV among trans women, conflation of this population with MSM has limited the information available on the social and behavioural factors that increase HIV vulnerability among trans women and how these factors may differ from MSM. Using data sets from quantitative studies among MSM (n = 645) and trans women (n = 89), as well as qualitative in-depth interviews with 30 trans women in Baltimore, we explore what these data tell us about similarities and differences in HIV vulnerability between the two groups and where they leave gaps in our understanding. We conclude with implications for data collection and intervention development.

KEYWORDS:

• HIV
• transgender women
• MSM
• intersectionality
• syndemic

Acknowledgements

The authors express our gratitude to the study participants for their willingness to share their data and their stories. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Additional information

Funding

We would like to acknowledge that the NHBS data collection was supported by contracts to The Johns Hopkins University from the Maryland Department of Health and Mental Hygiene and by cooperative agreements between the Maryland Department of Health and Mental Hygiene with the Centers for Disease Control and Prevention. Additional support for this project was received from the Johns Hopkins Center for Health Disparities Solutions and the Johns Hopkins Center for Public Health and Human Rights. The analyses described here were supported by the Johns Hopkins Center for AIDS Research, an NIH-funded program, with Award Number 1P30AI094189.