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The Social and Sexual Networks of Black Transgender Women and Black Men Who Have Sex with Men: Results from a Representative Sample.
Transgend Health 2018; 3(1):201-209TH

Abstract

Background:

Little research has evaluated the social and sexual network-related health outcomes of young black transgender women (TGW) or compared these outcomes with those of black men who have sex with men (MSM). Social network analysis offers one potent means of understanding the dynamics driving the broad spectrum of adverse outcomes experienced by these subgroups.

Methods:

We examined the social and sexual health network traits of 618 black individuals assigned male at birth who have sex with men, 47 (7.6%) of whom identified as TGW. Using respondent-driven sampling, data collection occurred over three waves between 2013 and 2016, in Chicago, Illinois. Univariate, logistic regression, and confidant and sexual network analyses were conducted to characterize dynamic network features.

Results:

TGW's mean age was 22.1 (standard deviation ±2.6). TGW's sexual networks were significantly less stable (stability ratio of 0.175 vs. 0.278 among MSM, p=0.03) and had greater network turnover (turnover ratio of 0.825 vs. 0.735, p=0.04). TGW also had significantly more sex partners (7.6 vs. 4.0, p=0.0002) and exchange sex (odds ratio=2.97; 95% confidence interval: 1.66-5.32, p<0.001), lower rates of employment (39.6% vs. 71.1%, p<0.001), and more reported an income <$20,000 (93.5% vs. 80.8%, p=0.029). Within confidant networks, TGW had a borderline significantly higher network turnover ratio (0.703 vs. 0.625, p=0.06). Furthermore, both TGW and MSM had high, but similar, HIV rates (42.3% vs. 30.6%, respectively; p=0.17). There were no significant structural network differences vis-à-vis mean degree (p=0.46), betweenness centrality (p=0.40), closeness centrality (p=0.18), or average shortest path length (borderline statistically significant at p=0.06).

Conclusion:

Using data from a representative sample of younger black individuals, we observed black TGW have less sexual network stability in contrast to black MSM but comparable structural network features. We further observed that both groups, and black TGW especially, possess considerable system-level, socioeconomic, and sexual health burdens.

Authors+Show Affiliations

Section of Infectious Diseases and Global Health, University of Chicago Medical Center, Chicago, Illinois. Department of Sociology, University of Chicago, Chicago, Illinois.Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois.NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, New York.Section of Infectious Diseases and Global Health, University of Chicago Medical Center, Chicago, Illinois. Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois. Department of Public Health Sciences, University of Chicago, Chicago, IL.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30581993

Citation

Ezell, Jerel M., et al. "The Social and Sexual Networks of Black Transgender Women and Black Men Who Have Sex With Men: Results From a Representative Sample." Transgender Health, vol. 3, no. 1, 2018, pp. 201-209.
Ezell JM, Ferreira MJ, Duncan DT, et al. The Social and Sexual Networks of Black Transgender Women and Black Men Who Have Sex with Men: Results from a Representative Sample. Transgend Health. 2018;3(1):201-209.
Ezell, J. M., Ferreira, M. J., Duncan, D. T., & Schneider, J. A. (2018). The Social and Sexual Networks of Black Transgender Women and Black Men Who Have Sex with Men: Results from a Representative Sample. Transgender Health, 3(1), pp. 201-209. doi:10.1089/trgh.2018.0039.
Ezell JM, et al. The Social and Sexual Networks of Black Transgender Women and Black Men Who Have Sex With Men: Results From a Representative Sample. Transgend Health. 2018;3(1):201-209. PubMed PMID: 30581993.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Social and Sexual Networks of Black Transgender Women and Black Men Who Have Sex with Men: Results from a Representative Sample. AU - Ezell,Jerel M, AU - Ferreira,Matthew J, AU - Duncan,Dustin T, AU - Schneider,John A, Y1 - 2018/12/18/ PY - 2018/12/25/entrez PY - 2018/12/26/pubmed PY - 2018/12/26/medline KW - HIV KW - gender identity KW - men who have sex with men KW - respondent-driven sampling KW - social networks KW - transgender women SP - 201 EP - 209 JF - Transgender health JO - Transgend Health VL - 3 IS - 1 N2 - Background: Little research has evaluated the social and sexual network-related health outcomes of young black transgender women (TGW) or compared these outcomes with those of black men who have sex with men (MSM). Social network analysis offers one potent means of understanding the dynamics driving the broad spectrum of adverse outcomes experienced by these subgroups. Methods: We examined the social and sexual health network traits of 618 black individuals assigned male at birth who have sex with men, 47 (7.6%) of whom identified as TGW. Using respondent-driven sampling, data collection occurred over three waves between 2013 and 2016, in Chicago, Illinois. Univariate, logistic regression, and confidant and sexual network analyses were conducted to characterize dynamic network features. Results: TGW's mean age was 22.1 (standard deviation ±2.6). TGW's sexual networks were significantly less stable (stability ratio of 0.175 vs. 0.278 among MSM, p=0.03) and had greater network turnover (turnover ratio of 0.825 vs. 0.735, p=0.04). TGW also had significantly more sex partners (7.6 vs. 4.0, p=0.0002) and exchange sex (odds ratio=2.97; 95% confidence interval: 1.66-5.32, p<0.001), lower rates of employment (39.6% vs. 71.1%, p<0.001), and more reported an income <$20,000 (93.5% vs. 80.8%, p=0.029). Within confidant networks, TGW had a borderline significantly higher network turnover ratio (0.703 vs. 0.625, p=0.06). Furthermore, both TGW and MSM had high, but similar, HIV rates (42.3% vs. 30.6%, respectively; p=0.17). There were no significant structural network differences vis-à-vis mean degree (p=0.46), betweenness centrality (p=0.40), closeness centrality (p=0.18), or average shortest path length (borderline statistically significant at p=0.06). Conclusion: Using data from a representative sample of younger black individuals, we observed black TGW have less sexual network stability in contrast to black MSM but comparable structural network features. We further observed that both groups, and black TGW especially, possess considerable system-level, socioeconomic, and sexual health burdens. SN - 2380-193X UR - https://www.unboundmedicine.com/medline/citation/30581993/The_Social_and_Sexual_Networks_of_Black_Transgender_Women_and_Black_Men_Who_Have_Sex_with_Men:_Results_from_a_Representative_Sample_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30581993/ DB - PRIME DP - Unbound Medicine ER -