Intimate Partner Violence and HIV/STI Prevention Among Transgender and Nonbinary Persons

J Interpers Violence. 2026 Jul 9:8862605261463259. doi: 10.1177/08862605261463259. Online ahead of print.

ABSTRACT

Transgender and nonbinary (trans) individuals experience high rates of intimate partner violence (IPV), contributing to elevated vulnerability to human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). While prior research has established associations between IPV and HIV risk, little is known about the mechanisms through which IPV affects engagement in HIV/STI prevention among trans populations. This study qualitatively explored how varied experiences of IPV may impact prevention behaviors, including pre-exposure prophylaxis (PrEP) use, condom negotiation, and HIV/STI testing, within the broader context of structural and interpersonal inequities. We conducted semi-structured interviews with 32 racially and ethnically diverse trans participants who reported IPV in a prior relationship and with 10 key informants who had experience working with this population. Interviews explored experiences of IPV, sexual health decision-making, and barriers to accessing sexual health services. Transcripts were analyzed using applied thematic analysis. Coding combined deductive and inductive approaches, and intercoder agreement was established through team consensus. Four major themes were identified: (1) partner directly interfering with HIV/STI prevention, in which abusive partners restricted access to PrEP, condoms, or HIV/STI testing as a form of control; (2) fear of partner reactions interfering with prevention engagement, where anticipated conflict or violence led survivors to avoid sexual health discussions or care; (3) structural barriers shaping sexual health and safety, highlighting how poverty, stigma, and lack of affirming care compounded IPV-related risks; and (4) gaps in services and suggestions for improvement, emphasizing the need for trauma-informed, gender-affirming, and community-driven interventions in this area. Findings illustrate how IPV may undermine HIV/STI prevention through both direct partner interference and indirect mechanisms rooted in fear, control, and systemic inequity. Addressing these barriers will require a combination of integrated, affirming, trauma-informed, and community-driven interventions that link IPV support with affirming sexual health services along with an expansion of existing IPV services to address the needs of trans people.

PMID:42427092 | DOI:10.1177/08862605261463259