Background: Approximately three in four transgender women in the United States have been tested for HIV in their lifetimes. However, estimates of repeated HIV testing are lower than other vulnerable populations. Experiences of discrimination have been associated with HIV testing avoidance. This study uses a quantitative intersectionality approach to explore transgender women of color’s discrimination experiences based on gender, race/ethnicity, and class, and the relationship between intersectional experiences of discrimination and HIV testing patterns.
Methods: A latent class analysis was conducted to identify classes based on the attributions of three social positions (gender identity, race/ethnicity, and income/education) to two experiences of discrimination (denial of services and verbal harassment) with a sample of 645 transgender women of color drawn from the 2015 U.S. Transgender Survey.
Results: Five distinguishable classes emerged: the largest class (59%) was characterized by verbal harassment attributed to gender; the second class (23%) by verbal harassment and denial of services attributed to gender; the third class (7%) by verbal harassment attributed to race/ethnicity; the fourth class (7%) by verbal harassment and denial of services attributed to gender and race/ethnicity; and the fifth class (4%) by verbal harassment and denial of services attributed to gender, race/ethnicity, and class. Participants in the third class had significantly higher probabilities of never having been tested for HIV compared to participants in the other classes.
Conclusions: An intersectional interpretation suggests that transgender women of color that only report ethnoracial verbal harassment might be benefitting from other people not being able to tell they are transgender and as a result might not face transmisogyny but also might not be targeted by HIV testing efforts. Moreover, findings suggest that HIV prevention interventions for transgender women of color that only address transmisogyny are likely insufficient in tackling the intersectional discrimination experiences contributing to HIV testing disparities.