Prior research has shown that male-to-female (MTF) transgender women of color in the United States have a high rate of HIV infection and often engage in sex work for economic survival. With the exception of studies on HIV prevalence and behavioral risk, little research exists to elucidate the social context and determinants of sex work and related health risks among these women. Through a qualitative analysis of seven focus groups with 48 transgender women of color, we examined why and how participants became involved in sex work, documented risks associated with sex work, and explored what motivated participants to remain in sex work. Participants reported on how social networks and cultural norms, immigration issues, and experiences of racism, sexism, and transphobia influenced their decisions to enter and the risks encountered in sex work. Findings revealed that transgender women of color who engage in sex work have unique needs and experiences that must be addressed through structural and social network-based interventions to minimize their vulnerability to social and public health harms.

• R01 DA11589/DA/NIDA NIH HHS/United States