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Table 3 Studies describing determinants associated with STBBI-related outcomes among trans sex workers in high-income countries

From: Preventing sexually transmitted and blood borne infections (STBBIs) among sex workers: a critical review of the evidence on determinants and interventions in high-income countries

Study Details Outcome Examined Multivariable Associations Reported
Author/Year Country Study Design/Dates Population STBBI Outcome Condom Use Outcome Individual & Interpersonal Determinants Structural Determinants
Clements-Nolle et al., 2008 [23] USA (San Francisco) Cross-sectional 190 trans women sex workers   Inconsistent condom use with clients (receptive anal sex) Inconsistent condom use with clients was positively associated with low self-esteem (aOR 3.09, 95%CI 1.28–7.47), a history of forced sex/rape (aOR 2.91, 95% CI 1.06–8.01), and crack-cocaine use (aOR 2.59, 95%CI 1.09–6.13)  
Dias et al., 2015 [40] Portugal Cross-sectional Jan-Sept 2011 1040 sex workers (81 trans, 106 male, 853 female) HIV prevalence (17.6% among trans; 7.4% among female; 5% among male)   HIV infection was positively associated with older age (over 25 compared to 18–25), trans identity (aOR 6.35, 95%CI 1.66–24.26), and ever use of psychoactive drugs (aOR 4.06, 95%CI 2.16–7.67) HIV infection was positively associated with lower (<€1000) monthly income (aOR 2.62, 95%CI 1.16–5.91) and working outdoors (aOR 5.43, 95%CI 1.90–15.56)
Nemoto et al., 2014 [24] USA (San Francisco and Oakland) Cross-sectional 2000–2001 & 2004–2006 573 trans women (53% with history of sex work)   Unprotected receptive anal sex with clients and non-paying partners Unprotected anal sex with commercial partner was inversely associated with norms towards healthy behaviors (aOR 0.39, 95%CI 0.15–0.98), and self-efficacy toward safe sex (aOR 0.27, 95%CI 0.10–0.76); Unprotected anal sex with primary partner was inversely associated with Latina ethnicity (aOR 028, 95%CI 0.09–0.88) norms towards healthy behaviors (aOR 0.51, 95%CI 0.31–0.85), and self-efficacy toward safe sex (aOR 0.48, 95%CI 0.25–0.91);
Unprotected anal sex with primary partner was positively associated with depression (aOR 2.58, 95%CI 1.24–5.38)
Unprotected anal sex with commercial partner was positively associated with exposure to transphobia (aOR 2.56, 95%CI 1.12–5.87)