{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T05:18:25Z","timestamp":1791695905178,"version":"4.3.4"},"reference-count":55,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"name":"Jamaica Forum for Lesbians, All-Sexuals and Gays"},{"name":"Caribbean Vulnerable Communities (CVC)"},{"name":"Aphrodite's Pride"},{"name":"Canadian Institutes of Health Research (CIHR)","award":["0000303157"],"award-info":[{"award-number":["0000303157"]}]},{"name":"Canadian Institutes of Health Research (CIHR)","award":["495419"],"award-info":[{"award-number":["495419"]}]},{"name":"Canadian Institutes of Health Research (CIHR)","award":["201209"],"award-info":[{"award-number":["201209"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Introduction<\/jats:bold>: Transgender women are disproportionately impacted by HIV. Transgender women involved in sex work may experience exacerbated violence, social exclusion, and HIV vulnerabilities, in comparison with non\u2010sex work\u2010involved transgender women. Scant research has investigated sex work among transgender women in the Caribbean, including Jamaica, where transgender women report pervasive violence. The study objective was to examine factors associated with sex work involvement among transgender women in Jamaica.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: In 2015, we implemented a cross\u2010sectional survey using modified peer\u2010driven recruitment with transgender women in Kingston and Ocho Rios, Jamaica, in collaboration with a local community\u2010based AIDS service organization. We conducted multivariable logistic regression analyses to identify factors associated with paid sex and transactional sex. Exchanging oral, anal or vaginal sex for money only was categorized as paid sex. Exchanging sex for survival needs (food, accommodation, transportation), drugs or alcohol, or for money along with survival needs and\/or drugs\/alcohol, was categorized as transactional sex.<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>: Among 137 transgender women (mean age: 24.0 [SD: 4.5]), two\u2010thirds reported living in the Kingston area. Overall, 25.2% reported being HIV\u2010positive. Approximately half (<jats:italic>n<\/jats:italic>\u00a0=\u00a071; 51.82%) reported any sex work involvement, this included sex in exchange for: money (<jats:italic>n<\/jats:italic>\u00a0=\u00a064; 47.06%); survival needs (<jats:italic>n<\/jats:italic>\u00a0=\u00a027; 19.85%); and drugs\/alcohol (<jats:italic>n<\/jats:italic>\u00a0=\u00a06; 4.41%). In multivariable analyses, paid sex and transactional sex were both associated with: intrapersonal (depression), interpersonal (lower social support, forced sex, childhood sexual abuse, intimate partner violence, multiple partners\/polyamory), and structural (transgender stigma, unemployment) factors. Participants reporting transactional sex also reported increased odds of incarceration perceived to be due to transgender identity, forced sex, homelessness, and lower resilience, in comparison with participants reporting no sex work involvement.<\/jats:p><jats:p><jats:bold>Conclusions<\/jats:bold>: Findings reveal high HIV infection rates among transgender women in Jamaica. Sex work\u2010involved participants experience social and structural drivers of HIV, including violence, stigma, and unemployment. Transgender women involved in transactional sex also experience high rates of incarceration, forced sex and homelessness in comparison with non\u2010sex workers. Taken together, these findings suggest that social ecological factors elevate HIV exposure among sex work\u2010involved transgender women in Jamaica. Findings can inform interventions to advance human rights and HIV prevention and care cascades with transgender women in Jamaica.<\/jats:p>","DOI":"10.7448\/ias.20.01\/21422","type":"journal-article","created":{"date-parts":[[2017,4,12]],"date-time":"2017-04-12T06:12:15Z","timestamp":1491977535000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Factors associated with sex work involvement among transgender women in Jamaica: a cross\u2010sectional study"],"prefix":"10.1002","volume":"20","author":[{"given":"Carmen H","family":"Logie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Lacombe\u2010Duncan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolette","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzma","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kandasi","family":"Levermore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava","family":"Neil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyrone","family":"Ellis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolette","family":"Bryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annecka","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"Newman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00684-X"},{"issue":"3","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"20774","DOI":"10.7448\/IAS.19.3.20774","article-title":"Characterizing the HIV risks and potential pathways to HIV infection among transgender women in Cote d'Ivoire, Togo and Burkina Faso","volume":"19","author":"Stahlman S","year":"2016","journal-title":"J Int AIDS Soc."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-011-0053-5"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-007-9210-3"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-007-9299-3"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/sgd0000029"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-005-9040-z"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1300\/J082v51n01_09"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","unstructured":"SeveliusJM KeatleyJ Gutierrez\u2010MockL.HIV\/AIDS programming in the United States: considerations affecting transgender women and girls.Womens Health Issues.2011;21(6 Suppl):S278\u201382.","DOI":"10.1016\/j.whi.2011.08.001"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2939"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.031484"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60833-3"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001124"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70315-8"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0117686"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31816e3971"},{"key":"e_1_2_11_18_1","volume-title":"The gap report.","author":"UNAIDS","year":"2014"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/19317611.2016.1223253"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-482"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxh005"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60931-4"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181fbc9ec"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2010.197285"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301241"},{"issue":"3","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"21193","DOI":"10.7448\/IAS.19.3.21193","article-title":"Evidence for action: a call for the global HIV response to address the needs of transgender populations","volume":"19","author":"Poteat TC","year":"2016","journal-title":"J Int AIDS Soc."},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.15.2.17392"},{"issue":"3","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"20801","DOI":"10.7448\/IAS.19.3.20801","article-title":"Putting the t in tools: a roadmap for implementation of new global and regional transgender guidance","volume":"19","author":"Wolf RC","year":"2016","journal-title":"J Int AIDS Soc."},{"key":"e_1_2_11_29_1","unstructured":"CIA. The world factbook: Jamaica.2016[cited 2016 Dec 14]. Available from:https:\/\/www.cia.gov\/library\/publications\/the\u2010world\u2010factbook\/geos\/jm.html."},{"key":"e_1_2_11_30_1","unstructured":"World Population Review. Population of cities in Jamaica (2016).2016[cited 2016 Dec 14]. Available from:http:\/\/worldpopulationreview.com\/countries\/jamaica\u2010population\/cities\/."},{"issue":"1","key":"e_1_2_11_31_1","first-page":"13","article-title":"Female sex tourism in Jamaica: an assessment of perceptions","volume":"6","author":"Spencer A","year":"2017","journal-title":"J Destin Market Manage."},{"key":"e_1_2_11_32_1","unstructured":"The Caribbean Vulnerable Communities Coalition (CVC) and El Centra de Orientacion E Investigacion Integral (COIN). Caribbean civil society showcase series: empower to prevent HIV a sex\u2010worker led intervention with police.2013[cited 2016 Dec 10]. Available from:http:\/\/www.cvccoalition.org\/sites\/default\/files\/CCSS_SWAJ.pdf."},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000172879.20628.e1"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1369-6513.2002.00158.x"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.2307\/3096941"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000093487.78664.3C"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705500802222972"},{"issue":"2","key":"e_1_2_11_39_1","first-page":"251","article-title":"Development of a brief scale for social support: reliability and validity in Puerto Rico","volume":"3","author":"Bernal G","year":"2003","journal-title":"Int J Clin Hlth Psychol."},{"issue":"16","key":"e_1_2_11_40_1","first-page":"927","article-title":"The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: findings from 3 US cities","volume":"9","author":"Diaz RM","year":"2001","journal-title":"Am J Public Health."},{"key":"e_1_2_11_41_1","volume-title":"Stata satistical software: release 12.","author":"StataCorp","year":"2011"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-014-0813-0"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1080\/19317611.2014.947055"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1300\/J082v51n03_04"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.02.003"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2004.010728"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1080\/00224499.2010.501916"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.11.1998"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-008-9508-8"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.14.6.351.24078"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.160051"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.01.028"},{"key":"e_1_2_11_53_1","unstructured":"Ministry of Health Jamaica.HIV epidemiological profile 2014 facts & figures.2014[cited 2016 Dec 10]. Available at:http:\/\/moh.gov.jm\/wp\u2010content\/uploads\/2015\/07\/2014\u2010HIV\u2010Epi\u2010Update.pdf."},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/jurban\/jth142"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30709-7"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30653-5"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.7448%2FIAS.20.01%2F21422","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.7448\/IAS.20.01\/21422","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T13:33:28Z","timestamp":1695562408000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.7448\/IAS.20.01\/21422"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1]]},"references-count":55,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.7448\/IAS.20.01\/21422"],"URL":"https:\/\/doi.org\/10.7448\/ias.20.01\/21422","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1]]},"assertion":[{"value":"2016-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-03-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-01-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"21422"}}