Testosterone and sexual risk among transmen: a mixed methods exploratory study

Area of Science:

• Transgender Health
• Sexual Health
• Public Health

Background:

• Limited research exists on the behavioral effects of testosterone use among transgender men (transmen) and its association with HIV risk.
• Understanding these behavioral changes is crucial for developing targeted HIV prevention strategies within the transgender community.

Purpose of the Study:

• To explore testosterone use patterns among transmen.
• To investigate the behavioral effects of testosterone, specifically focusing on changes in sexual behavior and partner preference.
• To assess the potential implications of these behavioral changes for HIV risk among transmen.

Main Methods:

• A mixed-methods study combining a quantitative cross-sectional survey (n=122) and qualitative focus group discussions (n=14) with transmen in San Francisco.
• Data collection focused on current hormone use, perceived behavioral effects of testosterone, and sexual partner demographics.

Main Results:

• A high prevalence of current hormone use (81.9%) was observed among participants.
• Testosterone use was associated with increased sexual activity (72%), new sexual behaviors (69%), and changes in sexual attraction (49%).
• A significant increase in sexual partnerships with cisgender men (from 3.3% to 25.4%) and transgender women (from 4.1% to 13.9%) was reported after starting testosterone.

Conclusions:

• Testosterone use in transmen is associated with shifts in sexual behavior and partner preference, including increased attraction to cisgender men.
• These changes may elevate HIV risk due to increased contact with populations experiencing higher HIV prevalence.
• The findings highlight the need for tailored HIV prevention and sexual health services for transmen, considering the context of transgender healthcare access.