Electronic Thesis and Dissertation Repository


Master of Science


Epidemiology and Biostatistics


Dr. Greta Bauer


Background: Studies examining HIV prevalence and risk behaviors within trans subgroups have identified them as high risk. Yet few studies have addressed how discrimination impacts this prevalence. Minority stress theory suggests that there is a relationship between minority stress and HIV-related risk behaviour. We hypothesize that multiple minority statuses may result in discriminatory experiences, specifically self-reported transphobia and racism in synchrony with other attributes, that interact to alter past-year HIV-related risk behaviour.

Methods: Data came from the Trans PULSE project, a mixed-methods, community-based research study that used respondent-driven sampling to access 433 trans Ontarians, between May 2009 and May 2010. RDSAT 6.0 was used to produce descriptive statistics and SAS 9.2 was used for regression analyses.

Results: Transphobia was commonly perceived as 97.8% (C.I. = 97.1%, 100.0%) of trans Ontarians reported at least one experience of transphobia, while 44.7% (C.I. = 36.6%, 52.5%) reported at least one instance of racism. Analysis of a multivariable logistic regression model predicting past-year HIV-related sexual risk behaviour among trans persons hints at an interaction between racism and sexual orientation and racism and ethnicity, as well as, transphobia and sexual orientation and transphobia and medical transition status, suggesting that transphobia and racism affects past-year HIV-related sexual risk behaviour differently across these groups.

Conclusions: The relationship between self-reported racism, self-reported transphobia and past-year HIV-related sexual risk behaviour is complex and interactive but limited. Our results contextualized HIV-related sexual risk behaviour showing the potential role of discrimination in determining sexual risk for trans persons.