Transgender men’s sexual health and HIV risk

Key take-home messages

• There is very little research about transmen’s sexual health, or their rates of HIV and STI infection. Existing research involving relatively small groups of transmen has found low rates of HIV infection.
• A systematic review of the HIV prevention needs of transgender people, published in 2008, found five US studies that reported information on rates of HIV among FTM:
  • Three studies in which participants self-reported their HIV status found HIV prevalence of 0%.
  • One study where participants self-reported HIV status found HIV prevalence of 3%.
  • In the only study where participants took antibody tests, the HIV prevalence rate among study participants was 2%.
• HIV risk among transmen is not well understood. A number sexual behaviours and sex-related behaviours put transmen at risk of becoming infected with, and transmitting, HIV and other STIs. An important finding from two relatively small studies of transgender people in the Philadelphia and Chicago regions was that transmen were significantly more likely than transwomen to engage in risky sexual behavior.
• Contextual factors — individual, interpersonal, and structural/societal factors — may affect the sexual health and HIV risk of transmen. While individual and interpersonal factors have been identified and discussed in the literature, virtually no research studies have been conducted to better understand their impact on the HIV risk for transmen.
• We did not find any published evaluations of HIV prevention interventions specific to transmen. One intervention used a pre-test and two post-test questionnaires (without a control group) to evaluate an intervention delivered to mixed groups of transgender men and women. The intervention appeared effective in improving participants’ attitudes toward condom use, safer sex self-efficacy and in reducing sexual risk behaviours.
• Numerous researchers, health care providers, academics, and community members call for more research into the lives and sexual health and HIV prevention needs of transgender people, or specifically of transmen.

• Population(s)
  • Transgender communities
• Prevention
  • Sexual risk behaviour