Transfemales have a high prevalence HIV, both in the United States, and internationally. Sexual partner-level factors such as injection drug use (IDU) have been indicated as important correlates of condomless anal intercourse (CAI), a risk behavior closely associated with HIV transmission. In the past several years, awareness of biomedical means of preventing HIV has greatly increased, and no studies have examined partner level correlates in this new context.
This secondary analysis examined partner-level demographic, substance use, and sexual behavior correlates of CAI using data from a diverse sample of dyads of transfemales and their sexual partners in San Francisco (N=840). Associations were calculated using multivariate logistic generalized estimating equations, adjusting participant HIV serostatus, participant biomedical prevention use, and partner type.
Factors associated with increased odds of CAI in multivariate analyses included main partner-type status (OR 2.62), having a partner who was cisgender male or transfemale (OR 21.25; OR 19.50, respectively), and being unaware of a partner’s injection drug use status (OR 2.02).
Our results mirror the findings of the earlier TEACH study, indicating that partner-level factors likely contribute to transmission for transfemales in significant ways. Public health researchers and officials should aim programs that focus on the partners of transfemales.