Dr. Henna Budhwani, assistant professor in the department of health care organization and policy at the University of Alabama at Birmingham, recently investigated the link between experiencing violence and the non-use of condoms among transgender female sex workers in the Dominican Republic, in collaboration with Dr. Bulent Turan, assistant professor in UAB’s department of psychology, and an international team of researchers from Centro de Orientación e Investigación Integral (COIN) in Santo Domingo. “Transgender women are a high-risk population, and transgender female sex workers are one of the most vulnerable populations globally. Transgender female sex workers have high rates of sexually transmitted infections, HIV, and exposure to violence compared to cisgender sex workers. These negative exposures are associated with an increase in HIV risk behaviors,” she reports.
[Photo: Dr. Henna Budhwani]
Among the study participants — who had an average age of 23 and had low levels of education — condom non-use was particularly high with coercive partners, such as police officers, landlords, and those in power over the sex worker. Using univariate analysis, logistic regression, and a mediation analysis, the researchers discovered high rates of negative exposures and that trust/distrust mediated the relationship between experienced violence and condom use/non-use.
The investigators concluded that use of condoms may be encouraged through the development of targeted interventions. As Dr. Budhwani states, “Developing interventions on increasing resilience and perceived self-worth, plus provision of screening for violence and referral services may reduce maladaptive attributions and cognitions about condom use. Furthermore, by implementing policies that protect vulnerable populations, and subsequently enforcing them, the Dominican Republic has the opportunity to improve overall population health and protect their most disadvantaged citizens.”
“Association between Violence Exposure and Condom Non-use among Transgender Sex Workers in the Dominican Republic: The Mediating Role of Trust” was published online in June in the International Journal of STD & AIDS.