# Gender-based differences in non-HIV STI testing among sexually active transgender and nonbinary persons: Bridging gaps in STI research

> **NIH NIH R03** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $78,000

## Abstract

PROJECT ABSTRACT
Research suggests that transgender (trans) populations, a diverse group of persons whose
gender identity and/or expression differ from societal expectations associated with their sex
labelled at-birth, have high rates of non-HIV sexually transmitted infections (STIs). Untreated non-
HIV STIs can contribute to negative health outcomes and community transmission. Therefore,
access to non-HIV STI testing is of critical importance to mitigate morbidity and promote public
health. Of the published research focused on non-HIV STI testing among trans people, studies
are limited in population focus (almost exclusively trans women). Notably absent are nonbinary
persons (those who do not identify exclusively as men or women), though this group comprises
1/3 of all trans people in the U.S. Scant literature has examined gender-based differences in non-
HIV STI testing among trans and nonbinary (TNB) populations. Moreover, information gaps also
exist regarding barriers and facilitators to non-HIV STI testing among TNB populations, and how
these barriers and facilitators may differ by gender. To address these gaps, our team will examine
whether sexually active TNB populations are characterized by gender-based differences (trans
women/trans men/nonbinary people) in their rates of non-HIV STI testing and barriers and
facilitators to non-HIV STI testing. We will conduct an explanatory sequential mixed-methods
study using secondary quantitative data from the 2018 Michigan Trans Health Survey (MTHS)
and a primary qualitative study of TNB persons using online focus groups. First, we will determine
gender-based differences in a) rates of lifetime non-HIV STI testing history (never, ever) and b)
time since last non-HIV STI test (never, past year, 1-5 years, >5 years) among sexually active
TNB persons. Then, informed by an integrated conceptual framework drawing on social ecology,
minority stress, and gender affirmation, we will examine whether individual (e.g., race/ethnicity),
medical (e.g., hormone therapy); social (e.g., provider discrimination based on gender identity);
and structural (e.g., clinic gender affirmation) factors are uniquely associated with lifetime non-
HIV STI testing history, and whether gender identity moderates the association between lifetime
non-HIV STI testing history and statistically significantly associated independent variables. Finally,
we will collect and analyze primary qualitative data from TNB persons to further understand their
barriers and facilitators to non-HIV STI testing. This study will inform future research focused on
developing, evaluating, and implementing interventions which increase non-HIV STI testing
among TNB populations, filling critical gaps in research specifically to the needs of overlooked
groups of trans men and nonbinary people.

## Key facts

- **NIH application ID:** 10334537
- **Project number:** 5R03AI159298-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Shanna Katz Kattari
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $78,000
- **Award type:** 5
- **Project period:** 2021-02-01 → 2023-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10334537

## Citation

> US National Institutes of Health, RePORTER application 10334537, Gender-based differences in non-HIV STI testing among sexually active transgender and nonbinary persons: Bridging gaps in STI research (5R03AI159298-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10334537. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*