TABLE 2.
Association Between Injection Drug Use and Select Demographic, Mental Health, Safety, and Discrimination Outcomes Among Transgender Women—NHBS-Trans, 7 US Cities, 2019–2020
| Total | Injected Drugs, Past 12 mo | Adjusted Models* | |||
|---|---|---|---|---|---|
| N† | n† | Row% | aPR (95% CI) | P | |
| Overall | 1558 | 104 | 6.7 | ||
| Race/ethnicity‡ | |||||
| Hispanic/Latina§ | 624 | 37 | 5.9 | Ref | |
| Black/African American | 547 | 35 | 6.4 | 1.40 (0.94 to 2.08) | 0.098 |
| White | 176 | 21 | 11.9 | 1.97 (1.34 to 1.40) | <0.001 |
| Gender identity | |||||
| Transgender woman | 1001 | 60 | 6.0 | Ref | |
| Woman | 174 | 12 | 6.9 | 1.19 (0.77 to 1.85) | 0.431 |
| Multiple genders listed | 383 | 32 | 8.4 | 1.29 (0.92 to 1.82) | 0.145 |
| Age group (yr) | |||||
| 18–29 | 483 | 27 | 5.6 | Ref | |
| 30–39 | 446 | 37 | 8.3 | 1.43 (0.74 to 2.74) | 0.288 |
| 40–49 | 293 | 18 | 6.1 | 0.95 (0.51 to 1.74) | 0.859 |
| ≥50 | 336 | 22 | 6.6 | 0.95 (0.53 to 1.69) | 0.851 |
| Education | |||||
| Less than high school | 335 | 25 | 7.5 | Ref | |
| High school or equivalent | 573 | 48 | 8.4 | 1.19 (0.67 to 2.12) | 0.560 |
| Some college or more | 648 | 31 | 4.8 | 0.63 (0.35 to 1.15) | 0.134 |
| Currently insured | |||||
| No | 262 | 12 | 4.6 | Ref | |
| Yes | 1295 | 92 | 7.1 | 1.56 (0.76 to 3.17) | 0.223 |
| Saw a health care provider, past 12 mo | |||||
| No | 100 | 5 | 5.0 | Ref | |
| Yes | 1458 | 99 | 6.8 | 1.37 (0.66 to 2.82) | 0.397 |
| Poverty level, past 12 mo | |||||
| Above poverty level | 567 | 33 | 5.8 | Ref | |
| Below poverty level | 977 | 71 | 7.3 | 1.25 (0.84 to 1.87) | 0.270 |
| Food insecurity, past 12 mo | |||||
| No | 646 | 22 | 3.4 | Ref | |
| Yes | 909 | 82 | 9.0 | 2.45 (1.50 to 4.01) | <0.001 |
| Has a disability | |||||
| No | 725 | 30 | 4.1 | Ref | |
| Yes | 825 | 73 | 8.9 | 1.85 (1.18 to 2.89) | 0.007 |
| Currently homeless | |||||
| No | 1201 | 49 | 4.1 | Ref | |
| Yes | 356 | 55 | 15.5 | 3.59 (2.54 to 5.07) | <0.001 |
| Incarcerated, past 12 mo | |||||
| No | 1285 | 62 | 4.8 | Ref | |
| Yes | 270 | 41 | 15.2 | 3.21 (2.32 to 4.44) | <0.001 |
| Social support | |||||
| Low/moderate | 848 | 45 | 5.3 | Ref | |
| High | 706 | 58 | 8.2 | 1.35 (0.84 to 2.15) | 0.214 |
| Noninjection drug use | |||||
| No | 628 | 19 | 3.0 | Ref | |
| Yes | 929 | 85 | 9.2 | 3.07 (1.97 to 4.79) | <0.001 |
| Mental health and safety outcomes | |||||
| Psychological distress, past 30 d | |||||
| No | 1151 | 66 | 5.7 | Ref | |
| Yes | 403 | 38 | 9.4 | 1.57 (1.06 to 2.32) | 0.024 |
| Verbally abused or harassed, past 12 mo | |||||
| No | 710 | 30 | 4.2 | Ref | |
| Yes | 846 | 74 | 8.8 | 1.96 (1.36 to 2.81) | <0.001 |
| Physical violence (including intimate partner violence), past 12 mo | |||||
| No | 1045 | 51 | 4.9 | Ref | |
| Yes | 512 | 53 | 10.4 | 2.04 (1.51 to 2.76) | <0.001 |
| Forced sex, past 12 mo | |||||
| No | 1321 | 73 | 5.5 | Ref | |
| Yes | 233 | 31 | 13.3 | 2.30 (1.62 to 3.29) | <0.001 |
| Received money or drugs for sex, past | 12 mo | ||||
| No | 1024 | 39 | 3.8 | Ref | |
| Yes | 534 | 65 | 12.2 | 3.23 (2.47 to 4.23) | <0.001 |
| Discrimination because of gender identity or presentation | |||||
| Trouble getting a job, past 12 mo | |||||
| No | 1032 | 61 | 5.9 | Ref | |
| Yes | 504 | 42 | 8.3 | 1.37 (0.96 to 1.98) | 0.085 |
| Denied access to appropriate bathroom, past 12 mo | |||||
| No | 1203 | 70 | 5.8 | Ref | |
| Yes | 348 | 34 | 9.8 | 1.68 (1.22 to 2.30) | 0.001 |
| Denied housing or evicted, past 12 mo | |||||
| No | 1333 | 75 | 5.6 | Ref | |
| Yes | 217 | 28 | 12.9 | 2.16 (1.65 to 2.82) | <0.001 |
| Denied health care, past 12 mo | |||||
| No | 1377 | 86 | 6.3 | Ref | |
| Yes | 169 | 17 | 10.1 | 1.49 (0.95 to 2.31) | 0.079 |
| Received poorer services, past 12 mo | |||||
| No | 942 | 44 | 4.7 | Ref | |
| Yes | 608 | 59 | 9.7 | 2.06 (1.46 to 2.90) | <0.001 |
*
Models adjusted for network size and MSA.
†
N’s do not include missing values.
‡
The other race/ethnicity categories were too small to report.
§
Hispanic/Latina can be of any race.