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Intersection of Transmisogyny, Racism, and Classism, and HIV Testing Patterns among Transgender Women of Color Open Access

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Background. Approximately three in four transgender women in the United States have been tested for HIV in their lifetime. 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, characterized by: verbal harassment attributed to gender (59%) ; verbal harassment and denial of services attributed to gender (23%); verbal harassment attributed to race/ethnicity (7%); verbal harassment and denial of services attributed to gender and race/ethnicity (7%); and verbal harassment and denial of services attributed to gender, race/ethnicity, and class (4%). Participants in the class characterized by verbal harassment attributed to race/ethnicity had significantly a higher probability of never having been tested for HIV compared to participants in the other classes. Discussion. 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 social processes of discrimination contributing to HIV testing disparities.

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