Relationship Stigma and HIV Risk Behavior Among Cisgender Men Partnered with Transgender Women: The Moderating Role of Sexual Identity.
Kristi E Gamarel, Jae M Sevelius, Sari L Reisner, Raha L Richardson, Lynae A Darbes, Tooru Nemoto, Don Operario
Author Information
Kristi E Gamarel: Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA. kgamarel@umich.edu. ORCID
Jae M Sevelius: Department of Family and Community Medicine, Center of Excellence for Transgender Health, University of California, San Francisco, CA, USA.
Sari L Reisner: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Raha L Richardson: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Lynae A Darbes: Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA.
Tooru Nemoto: Public Health Institute, Oakland, CA, USA.
Don Operario: Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
Cisgender men partnered with transgender women are an understudied and hard to engage population in HIV prevention efforts. Relationship stigma-the anticipation of negative treatment based on having a relationship with a member of a stigmatized group-has been linked to adverse health behaviors, but it remains unclear whether different sources of relationship stigma (i.e., family, friends, and the general public) are associated with HIV risk behaviors and whether these associations may vary by men's sexual identities (e.g., gay, bisexual, and heterosexual). The current study examined associations between relationship stigma and HIV risk behaviors and whether these associations were moderated by sexual identity. We recruited a convenience sample of 185 cisgender men in primary partnerships with transgender women to participate in a one-time survey. Gay identified men reported greater levels of relationship stigma from the general public compared with heterosexually identified men. In multivariable models, higher levels of relationship stigma from the public were associated with increased odds of engaging in drug use prior to having condomless sex and receiving an STI diagnosis in the last 30 days. There were significant interaction effects such that higher levels of relationship stigma from the public were associated with both indicators of HIV risk for gay identified men but not for heterosexually identified men. Findings support the importance of HIV prevention approaches accounting for relationship stigma from the general public and the diverse sexual identities of men partnered with transgender women when seeking to increase linkage to and engagement in HIV prevention services, including biomedical prevention strategies.
