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Melendez RM, Pinto R. 'It's really a hard life': love, gender and HIV risk among male-to-female transgender persons. Cult Health Sex 2007; 9 (3): 233-45.

Objective: Scientific studies demonstrate high rates of HIV infection among male-to-female (MTF) transgender individuals and that stigma and discrimination place MTFs at increased risk for infection. However, there is little research examining how gender roles contribute to HIV risk.
Methods: This paper reports on in-depth interviews with 20 MTFs attending a community clinic.
Results and discussion: Data reveal that stigma and discrimination create a heightened need for MTFs to feel safe and loved by a male companion and that in turn places them at a higher risk for acquiring HIV. Male-to-female transgender individuals appear to turn to men to feel loved and affirmed as women; their main HIV risk stems from their willingness to engage with sexual partners who provide a sense of love and acceptance but who also may also request unsafe sexual behaviours. A model illustrating how HIV risk is generated from stigma and discrimination is presented.