AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #121 - Hiv risk among male-to-female transgender individuals in Bogotá, Colombia
Authors: Presenting Author: Ms. Felisa Gonzales - George Washington University
Additional Authors: Mr. Rodrigo Aguayo Romero , Ms. Ana Maria Del Rio Gonzalez, Mr. Carlos Fabian Betancourt, Ms. Marcela Aguilar Pardo, Ms. Fernanda T. Bianchi, Ms. Maria Cecilia Zea, Ms. Carol A. Reisen, Mr. Paul J. Poppen,
Aim: The sexual risk behaviors of transgender women in Argentina (Toibaro et al., 2009) and the social, cultural, and socioeconomic influences on transgender women working as sex workers in Mexico (Infante, Sosa-Rubi, & Cuadra, 2009) have been documented. The current exploratory study utilizes qualitative data obtained from transgender women living in Bogotá, Colombia as part of a larger study on Colombian men who have sex with men. The objectives were to increase knowledge of Latin American transgender individuals’ living conditions and sexual practices in order to elucidate factors influencing HIV risk behaviors in this vulnerable population.
Method / Issue: Fourteen male-to-female transgender individuals participated in life history interviews and another 11 participated in a focus group. All participants responded to questions regarding sexual development, identity and behavior. The focus group and interviews were conducted, tape-recorded and transcribed in Spanish by Colombian researchers. An inductive data micro-coding process was completed using NVivo8 software for textual analysis by a team of five Latino researchers, two of whom were in Colombia and three of whom were in the US. At least two team members coded each interview, and the fifth team member reviewed the work of both groups to identify areas of disagreement. Discrepancies were brought back to the group of researchers from both countries for discussion and resolution in weekly meetings using Skype technology.
Results / Comments: Participants often described how their sexual orientation impacted their interpersonal relationships and economic opportunities. They noted that discrimination and a lack of employment opportunities for transgender persons often resulted in engagement in sex work. Sex work provided money to cover living costs, but was also frequently mentioned as a means of paying for costs associated with demonstrating a feminine identity (e.g., purchase of make-up and female clothing). Participants reported both safe and risky sexual practices. The transgender persons in this small sample reported consistent condom use with clients, but less consistent use with regular intimate partners. Although they were often solicited for unprotected sex (both insertive and receptive), nearly all reported condom use as being non-negotiable in their commercial sexual encounters. Several participants reported using drugs and alcohol while soliciting potential clients, although substance use was frequently described as more of a social activity with other sex workers than at the behest of the client. Most of the transgender persons in the sample were very knowledgeable about HIV/AIDS and their elevated risk; however, many were not obtaining regular HIV tests despite availability through community organizations serving this population.
Discussion: Our preliminary results indicate that survival sex is the only viable employment option for many transgender women living in Bogotá. Interventions promoting condoms and safe sex appear to have been successful in educating many transgender sex workers of the need to use condoms with clients, but future interventions should emphasize the need for condom use in stable relationships where at least one partner is not regularly being tested. Interventions should also encourage regular HIV testing and educate participants about the importance of treatment if they have tested positive.
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