Prevalence and Correlates of Depressive Symptoms Among Travestis and Transgender Women in Rio de Janeiro, Brazil: A Cross-Sectional Study

Purpose: This study assessed the prevalence and correlates of depressive symptoms among travestis and transgender women in Rio de Janeiro, Brazil. Methods: We conducted a cross-sectional analysis of the Transcendendo cohort (2015–2023) using baseline data from travestis and transgender women aged ≥18. Depressive symptoms were evaluated using the 10-item Center for Epidemiological Studies Depression Scale score ≥10. Sociodemographics, HIV status, at-risk substance use, violence victimization, and sexual partnership characteristics were analyzed as correlates in a modified Poisson regression model with a log link and robust variance to obtain adjusted prevalence ratios (aPRs) and 95% confidence intervals (95% CIs). Results: A total of 885 participants were included, with a median age of 29 years (interquartile range = 24–38), 73.3% identified as Black/Parda, and 65.9% had more than 8 years of education. A high percentage (89.4%) screened positive for depressive symptoms. In the multivariable analysis, depressive symptoms were significantly associated with sexualized drug use in the past 6 months (aPR = 1.08; 95% CI = 1.01–1.16; p = 0.032), lifetime sexual assault (aPR = 1.05; 95% CI = 1.00–1.10; p = 0.029), and recent tobacco use (aPR = 1.05; 95% CI = 1.00–1.10; p = 0.040). Having a stable partner was associated with a lower prevalence of depressive symptoms (aPR = 0.90; 95% CI = 0.84–0.96; p = 0.002). Conclusions: This study found a high prevalence of depressive symptoms among travestis and transgender women, with correlates including sexualized drug use, sexual assault, and tobacco use. These findings highlight the need to expand mental health services, address trauma, and implement harm reduction approaches for substance use in this population.