Sexual Risk Behaviors Among the Transgender and Gender Diverse Population: A Concept Analysis

This concept analysis aims to create an understanding of sexual risk behavior (SRB) definitions among transgender and gender diverse (TGD) adults. SRBs are inconsistently defined across research and clinical practice among TGD adults. One major consequence of SRBs is risk of sexually transmitted infections (STI). TGD populations experience a high burden of STIs, but the varied ways in which SRBs are evaluated do not give sufficient information for researchers to examine nuanced predictors and outcomes of SRBs, which are ultimately needed to develop targeted interventions for reduction of risk behaviors. This concept analysis was conducted using Rodgers' evolutionary method which guided the literature search, data analysis, and results. The articles included in this analysis were gathered from PubMed, CINAHL, and Embase. After title and abstract screenings, 95 articles were reviewed in full, and 63 articles were included within this analysis. Consistent antecedents of SRB were socioeconomic status, race, gender, violence, alcohol/drug use, and mental health. Attributes included several ways of defining SRBs such as frequency of condom use and type of partners. The most consistent outcome of SRBs was contraction of STIs and subsequent health problems. Few studies examined mental health outcomes of SRBs. Future research should create a standardized tool for measuring SRBs to inform policy for providing sexual health education to TGD populations, which will ultimately decrease disparities in STIs. Keywords: transgender care, sexual risk behavior, sexual health