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Health Disparities, Risk Behaviors and Healthcare Utilization Among Transgender Women in Los Angeles County: A Comparison from 1998–1999 to 2015–2016

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Abstract

Data from two studies of transgender women in Los Angeles County that used the same methodology and survey assessment (Study 1: 1998–1999, N = 244; Study 2: 2015–2016, N = 271), compared structural determinants of health, HIV/STI prevalence, HIV risk behaviors, substance use, gender confirmation procedures, and perceived discrimination and harassment/abuse across a 17-year time period. Findings demonstrated that participants in the latter study reported significantly higher access to healthcare insurance and prescription hormones. However, participants in the latter study also reported lower levels of income; and, elevated prevalence of homelessness, HIV and lifetime STIs, receptive condomless anal intercourse with casual partner(s), and reported physical harassment/abuse. Given the timeframe of these results, these findings elucidate specific areas of transgender women’s health and risk profiles that improved or worsened across 17 years. While healthcare access has improved, transgender women continue to face significant barriers to good health, indicating the need for increased attention to this population.

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Acknowledgements

The authors would like to acknowledge the work of the research assistants from both Study 1 and Study 2 and their dedication to serve their community, and the participants in both studies.

Funding

Study 1 was supported by the California HIV/AIDS Research Program (formerly University of California Universitywide AIDS Research Program) Grant #PC97-LAC-012L and Study 2 was supported by the National Institute on Drug Abuse, Grant #R21DA037816. Dr. Reback acknowledges additional support from the National Institute of Mental Health (P30 MH58107). Ms. Clark acknowledges funding support from the UCLA Graduate Division and UCLA Fielding School of Public Health (Fellowship in Epidemiology, 2016–2017). Dr. Holloway acknowledges funding support from the California HIV/AIDS Research Program (RP15-LA-007).

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Authors and Affiliations

  1. Friends Research Institute, Inc., 1419 N. La Brea Ave, Los Angeles, CA, 90028, USA

    Cathy J. Reback & Jesse B. Fletcher

  2. David Geffen School of Medicine, Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA

    Cathy J. Reback

  3. Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, CA, USA

    Cathy J. Reback & Ian W. Holloway

  4. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA

    Kirsty Clark

  5. Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA

    Ian W. Holloway

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  1. Cathy J. Reback
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  2. Kirsty Clark
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  4. Jesse B. Fletcher
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Correspondence to Cathy J. Reback.

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The authors declare no conflicts of interest.

Ethical Approval

All procedures in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable standards.

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Written informed consent was obtained from all participants.

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Reback, C.J., Clark, K., Holloway, I.W. et al. Health Disparities, Risk Behaviors and Healthcare Utilization Among Transgender Women in Los Angeles County: A Comparison from 1998–1999 to 2015–2016. AIDS Behav 22, 2524–2533 (2018). https://doi.org/10.1007/s10461-018-2165-7

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