1. Housing discrimination, housing status, and HIV risk behavior among U.S. mid-Atlantic sexual and gender minority individuals Ariella R. Tabaac 1, Laurie A. Cathers 1, Ted Heck 2, Juan Pierce 3, Shawn McNulty 4, Cheuk Chi Tam 1, Larissa Jennings 5, Rick Zimmerman 6, Eric Benotsch 1 1 Virginia Commonwealth University, 2 Virginia Department of Health, 3 Minority Health Consortium, 4 Fan Free Clinic, 5 Johns Hopkins University, 6 University of Missouri Results As shown in Figure 3, rates of housing discrimination and housing instability were relatively high, especially for transgender women. Among transgender women, participants who reported housing discrimination were more likely to report housing instability (83%) compared to participants who did not report housing discrimination (42%), χ 2 (1, N = 116) = 16.53, p <.001. Similarly among MSM, housing instability was more common among individuals who reported housing discrimination (75%) versus those who did not (24%), χ 2 (1, N = 215) = 20.42, p <.001. The same pattern was seen in transgender men, with participants who reported housing discrimination being more likely to report unstable housing (66%) relative to participants who reported no housing discrimination (22%), χ 2 (1, N = 57) = 4.88, p <.05. Introduction Housing discrimination and homelessness are growing problems within the lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations. In the National Transgender Discrimination Study over 19% of respondents reported housing discrimination (Grant et al., 2011). Regional needs-assessments across the United States have similar findings (Bradford et al., 2012; Xavier, Bobbin, Singer, & Budd, 2004), with transgender samples often reporting homelessness and experiences of housing discrimination (e.g., being denied housing or shelter). Studies of lesbian, gay, and bisexual adults have similarly found high rates of housing discrimination, where lesbian and gay individuals report higher rates of discrimination than bisexual individuals (Herek, 2009). Current literature on the correlates of housing discrimination among LGBTQ individuals is limited. Transgender individuals who have experienced homelessness report heightened rates of verbal, physical, and sexual harassment from shelter staff or residents (22- 55%), police abuse, and negative health outcomes (Grant et al., 2011). Qualitative research of homeless gay and transgender youth have identified harassment, violence, lack of financial support, and sexual commodification as potential risk factors (Grossman & D’Augelli, 2006; Reck, 2009). Given previous links between perceived discrimination and HIV risk behaviors in gay and transgender samples (Hatzenbuehler, Nolen-Hoeksema, & Erickson, 2008; Sugano, Nemoto, & Operario, 2006), it is likely that housing discrimination has a similar influence on risk behaviors. The aim of this study was to examine the relationships between housing discrimination, sexual orientation and gender identity, and HIV risk behaviors. Methods Participants recruited from community venues in Richmond, VA and Washington, DC completed a self- administered, anonymous survey that took approximately 15 minutes to complete. Participants were paid a $10 incentive. We assessed housing discrimination based on sexual orientation or gender identity, stability of housing in the past 12 months, and HIV risk behavior. Housing discrimination based on sexual orientation or gender identity was assessed with the item: “In the past year, were you denied a place to live or did you lose a place to live because of your gender identity / sexual orientation?” with response choices of Yes or No. Housing instability was assessed with the item: “In the last year, has there ever been a time when you did not have your own place to stay (apartment or home)? (For example, you stayed with a friend, or at a shelter, hotel, or on the streets)” with response choices of Yes or No. The findings of increased likelihood of experiencing housing instability due to housing discrimination among TGW, TGM, and MSM are congruent with national rates of homelessness among these populations (Grant et al., 2011; Herek, 2009), and indicate housing discrimination among LGBTQ DC and Richmond, VA residents follow patterns similar to housing discrimination experienced by these populations across the United States. The finding of increased likelihood of experiencing housing discrimination among TGM is novel, as few studies have examined housing discrimination in this population. The link between unstable housing and recent CSW holds important implications, as CSW among MSM and TGW has been previously associated with heightened risk for negative health outcomes, particularly HIV (Operario, Soma, & Underhill, 2008; Stephens et al., 2000; Estcourt et al., 2000; Pisani et al., 2004). Discussion Selected Reference Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Keisling, M. (2011). Injustice at every turn: A report of the national transgender discrimination survey. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force. Full list of references available by request. Please direct emails to Ariella Tabaac at tabaacar@vcu.edu. Methods (cont.) As shown in Figure 4, housing instability was associated with recent (past 3 months) commercial sex work. Controlling for age, race, education, and LGBT group, unstable housing was associated with recent commercial sex work (CSW), OR = 2.94 (95% CI = 1.48, 5.84), p <.01 as well as having multiple vaginal/anal sex partners in the past 3 months, OR = 2.08 (95% CI = 1.27, 3.40) p <.01. A Sobel test indicated that the relationship between housing instability and multiple sex partners was partially mediated by CSW, Z = 2.70, p <.01. The mean age of participants was 28.6 (SD = 9.9). Participants reported an average of 12.9 years of formal education (SD = 1.9). Almost one fifth of participants (18.9%) reported an HIV- positive serostatus. Results (cont.) Figure 3. Housing discrimination and housing instability. Figure 4. Housing instability and commercial sex work. Figure 2. Participant race/ethnicity. Figure 1. Participant LGBT group.