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AIDS and Behavior
Published in: AIDS and Behavior 6/2019

01-06-2019 | Original Paper

Syndemic Classes, Stigma, and Sexual Risk Among Transgender Women in India

Authors: Venkatesan Chakrapani, Tiara C. Willie, Murali Shunmugam, Trace S. Kershaw

Published in: AIDS and Behavior | Issue 6/2019

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Abstract

Syndemic theory could explain the elevated HIV risk among transgender women (TGW) in India. Using cross-sectional data of 300 TGW in India, we aimed to: identify latent classes of four syndemic conditions (Depression-D, Alcohol use-A, Violence victimization-V, HIV-positive status), test whether syndemic classes mediate the association between stigma and sexual risk, and test whether social support and resilient coping moderate the association between syndemic classes and sexual risk. Four distinct classes emerged: (1) DAV Syndemic, (2) AV Syndemic, (3) DV Syndemic, and (4) No Syndemic. TGW in the DAV Syndemic (OR 9.80, 95% CI 3.45, 27.85, p < 0.001) and AV Syndemic classes (OR 2.74, 95% CI 1.19, 6.32, p < 0.01) had higher odds of inconsistent condom use in the past month than the No Syndemic class. Social support significantly moderated the effect of DAV Syndemic class on inconsistent condom use. DAV Syndemic was found to be a significant mediator of the effect of transgender identity stigma on sexual risk. HIV prevention programs among TGW need to: (a) incorporate multi-level multi-component interventions to address syndemic conditions, tailored to the nature of syndemic classes; (b) reduce societal stigma against TGW; and (c) improve social support to buffer the impact of syndemics on sexual risk.
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Metadata
Title
Syndemic Classes, Stigma, and Sexual Risk Among Transgender Women in India
Authors
Venkatesan Chakrapani
Tiara C. Willie
Murali Shunmugam
Trace S. Kershaw
Publication date
01-06-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue 6/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-018-2373-1

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