Non-medical use of prescription drugs and HIV risk behaviour in transgender women in the Mid-Atlantic region of the United States

Abstract

Male-to-female transgender women (TGW) experience high rates of substance use and HIV. A recent substance use trend is the use of prescription medication without a doctor's consent. No research to date has examined the associations between this non-medical use of prescription drugs and HIV risk behaviour in TGW. In the present study, TGW recruited from community venues (N = 104) in the Mid-Atlantic region of the United States completed surveys assessing demographic information, non-medical use of prescription drugs, other substance use, injection practices and sexual risk behaviour. Twenty-four per cent of the sample reported lifetime non-medical use of prescription drugs across the following categories: analgesics (21.2%), anxiolytics (14.4%), stimulants (12.5%) and sedatives (8.7%). Participants reporting non-medical use of prescription drugs were more likely to report other substance use, needle use to inject drugs, injecting silicone and sharing needles. In multivariable analyses, non-medical use of prescription drugs was associated with unprotected sex, sex after engaging in substance use, and commercial sex work, after controlling for demographic factors. Self-esteem and social support from family served as protective factors for non-medical use of prescription drugs. HIV-prevention programmes focused on TGW in the United States may wish to expand their assessment of substance use to include the use of prescription medications without a physician's consent.

HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action

“…Despite significant health risks [24–27], soft tissue fillers are commonly injected in the face, breast, and hips and/or buttocks of transgender women to feminize the contour of the face and body [28]. High rates of substance use have been reported in studies in both transgender women and transgender men [29, 30]. In one study, transgender women reporting substance use of any nature were more likely to report needle use to inject drugs, injecting silicone, and sharing needles [29].…”

“…High rates of substance use have been reported in studies in both transgender women and transgender men [29, 30]. In one study, transgender women reporting substance use of any nature were more likely to report needle use to inject drugs, injecting silicone, and sharing needles [29]. Injection drug use has been associated with testing positive for HIV among transgender women [12].…”

Dermatologic care for lesbian, gay, bisexual, and transgender persons

“…116 Many transgender women have received illicit "silicone" or "filler" injections in the buttocks, hips, breasts, face, or calves from unlicensed, low-cost "pumpers." 88,[117][118][119] Injected substances have included food-or industrial-grade silicone, paraffin, petroleum jelly, lanolin, beeswax, various oils, tire sealant, cement glue, and automobile transmission fluid; volumes have ranged from 2 ounces to 8 liters. 117 Serious complications, including foreign-body granulomas, bacterial or atypical mycobacterial infections, bleeding, pain, scarring, ulceration, fistula formation, gross disfiguration, lymphedema, silicone migration or embolism, sepsis, hypersensitivity pneumonitis, and death have occurred hours to decades later.…”

HIV, HCV, HBV, and syphilis among transgender women from Brazil

“…However, some studies have addressed the multiple burdens associated with female TGW who use multiple substances, among them injectable illicit substances as well as silicone. So far, the focus has been on different associated harms and HIV infection [ 15 ] and very scarce information is available about HCV infection.…”