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Intimate Partner Violence and HIV Prevention Among Transgender and Nonbinary Persons: Protocol for a Prospective
Erik D Storholm1,2,3, Keith J Horvath4, Adedotun Ogunbajo2
1School of Public Health, San Diego State University, San Diego, CA, United States.
JMIR Research Protocols
|December 30, 2025
Summary
Transgender and nonbinary individuals experiencing intimate partner violence (IPV) face higher HIV risks. This study examines how IPV affects HIV prevention behaviors like testing and PrEP use in this population.
Area of Science:
- Public Health
- Sociomedical Sciences
- Epidemiology
Background:
- Transgender and nonbinary (TNB) individuals experience intimate partner violence (IPV) at twice the rate of cisgender populations.
- IPV is linked to increased HIV risk and vulnerability among TNB persons, but its impact on prevention behaviors is understudied.
- IPV experiences are complex and intersect with systemic marginalization, necessitating research into specific mechanisms.
Purpose of the Study:
- To investigate the risk and protective pathways between IPV (perpetration and victimization) and HIV-related outcomes in TNB individuals.
- To understand how IPV influences condomless sex, STI acquisition, and pre-exposure prophylaxis (PrEP) uptake, adherence, and persistence.
- To inform tailored HIV prevention strategies for TNB communities affected by IPV.
Main Methods:
- A prospective, sequential mixed-methods cohort study involving two phases.
- Phase 1: Qualitative interviews with 32 TNB individuals with recent IPV experience and 10 key informants.
- Phase 2: A 24-month longitudinal web-based cohort study of 600 HIV-negative, partnered TNB individuals, including surveys and at-home biospecimen collection for HIV/STI testing and PrEP adherence.
Main Results:
- Phase 1 qualitative interviews were conducted from October 2023 to October 2024.
- Rapid qualitative analysis was completed by January 2025 to inform Phase 2 measurement selection.
- Phase 2 enrollment began in February 2025 and is expected to continue through December 2025.
Conclusions:
- The study will provide critical insights into the relationship between IPV and HIV risk/prevention among TNB individuals.
- Findings will guide the development of gender-affirming, trauma-responsive, and culturally grounded interventions.
- This research aims to improve HIV prevention tailored to the unique needs of TNB communities.
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