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

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)