Food Insecurity Associations with HIV-Related Behaviors Among Transgender Women in the U.S. Open Access
Shatz, Gabriella (Spring 2025)
Abstract
Purpose: The aim of this study is to evaluate the prevalence of food insecurity among transgender women and to investigate the associations between HIV-related behaviors and food insecurity.
Methods: In 2023, 1,892 transgender women and transfeminine persons who were 15+ years of age, living in the United States, and sexually active were recruited for an online behavioral survey through social media advertisements. The study evaluated sexual behaviors, mental health, and experience with stigma. Multiple modified multivariable Poisson regressions were used to examine associations between food insecurity and demographics and HIV-related behaviors.
Results: Over half of participants were aged 15-24 years, were White non-Hispanic persons, and had only private health insurance. The prevalence of food insecurity was found to be 37% (708/1892). Food insecurity prevalence was found to vary significantly by age group, income, education, health insurance, and a history of homelessness. After controlling for these covariates, significant moderate to weak positive associations were found between food insecurity and condomless anal sex, heavy alcohol consumption, illicit non-injection drug use, and receiving money and goods in exchange for sex, respectively.
Conclusion: By evaluating food insecurity and HIV-related behaviors, it is evident how transgender women are negatively impacted by these associations. To combat these disparities, targeted resources addressing food insecurity, condom accessibility, substance use, and mental health are urgently needed within the transgender women population.
Table of Contents
Introduction…………………………………………………………………………………………………1
Methods……………………………………………………………………………………………………..2
Results………………………………………………………………………………………………………5
Discussion…………………………………………………………………………………………………..6
References…………………………………………………………………………………………………10
Table 1……………………………………………………………………………………………………..17
Table 2……………………………………………………………………………………………………..21
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