HIV prevalence was eight times higher among trans- compared to cisgender female sex workers in a Baltimore study published in Journal of Acquired Immune Deficiency Syndrome.
Structural vulnerabilities, including experiences of childhood abuse and client violence, were common among all 324 women, 62 of whom were transgender. However, there were racial disparities among this sample of street-based sex workers: 66% of cis women where white compared to none of the trans women, while 76% of trans women were African American compared to 23% of cis women. Latinas accounted for 11% and 24% of cis- and transgender participants, respectively.
"Given the different racial demographics by gender identity in this study, our findings could suggest how experiences of race and racism may intersect with transphobia to compound HIV risk beyond traditional risk factors," the study authors wrote.
Other differences included injection drug use, which was more common among cis than trans women, and early entry into sex work, which was more common among trans than cis participants. Most trans participants knew their serostatus and those living with HIV were more likely to use condoms than HIV negative trans participants.
HIV testing and PrEP for trans women sex workers could decrease the levels of HIV in that community, study authors concluded.