Syndemic conditions, hiv transmission risk behavior, and transactional sex among transgender women

Jeffrey T. Parsons, Nadav Antebi-Gruszka, Brett M. Millar, Demetria Cain, Sitaji Gurung

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


This study examined the effect of four syndemic conditions—namely, polydrug use, depression, childhood sexual abuse, and intimate partner violence—on rates of HIV transmission risk behavior (TRB) and separately, transactional sex among transgender women. TRB was defined as the number of condomless penetrative sex events with a casual or main partner of discordant or unknown HIV status. Using data from 212 transgender women in New York City, multivariable analyses revealed that, compared to those with no syndemic conditions, dramatically higher rates of recent HIV TRB events (ARR = 8.84, p < 0.001) and recent transactional sex events (ARR = 8.32, p < 0.001) were reported by participants with all four syndemic conditions. These findings highlight the importance of considering the role of syndemic conditions in HIV risk among transgender women, and the need for comprehensive psychosocial interventions to improve sexual health among this population.

Original languageEnglish (US)
Pages (from-to)2056-2067
Number of pages12
JournalAIDS and behavior
Issue number7
StatePublished - Jul 2018
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


  • Hiv transmission risk behavior
  • Syndemics
  • Transactional sex
  • Transgender women


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