Farzana Kapadia
Associate Professor of Epidemiology
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Professional overview
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Dr. Farzana Kapadia is an epidemiologist interested in understanding the distribution, determinants, and consequences of HIV/AIDS across the lifespan. In adolescents and younger adults, Dr. Kapadia is interested in studying contextual factors that influence HIV/AIDS related health behaviors and outcomes. Given the increasingly chronic nature of HIV/AIDS, she also studies the impact of HIV/AIDS on the physical, mental, and behavioral health of older HIV+ adults.
Dr. Kapadia is co-Director of the Center for Health, Identity, Behavior, and Prevention Studies and is affiliated with the Institute of Human Development and Social Change and the NYU Population Center. She has taught courses in Introductory Epidemiology (graduate- and undergraduate-level), Intermediate Epidemiology, and Research Methods in Public Health, and History & Principles of Public Health.
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Education
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BS, Biology and History, SUNY Binghamton, Binghamton, NYMPH, Community Public Health, New York University, New York, NYPhD, Epidemiology, Columbia University, New York, NY
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Honors and awards
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Excellence in Public Health Faculty Award, New York University (2012)Steinhardt Goddard Award (2011)Community Collaborative Award, Steinhardt School of Culture, Education and Human Development (2009)Elected Member, American College of Epidemiology (2007)
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Areas of research and study
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Behavioral Determinants of HealthEpidemiologyHIV/AIDSReproductive HealthSocial BehaviorsSocial Determinants of HealthSubstance Abuse
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Publications
Assessing Gaps in the HIV Care Continuum in Young Men Who Have Sex With Men: The P18 Cohort Study
Greene, R.E., Luong, A., Barton, S.C., Kapadia, F., & Halkitis, P.Publication year
201810.1016/j.jana.2017.12.004Journal title
Journal of the Association of Nurses in AIDS CareAcceptability of ecological momentary assessment among young men who have sex with men
AbstractDuncan, D.T., Kapadia, F., Kirchner, T., Goedel, W.C., Brady, W.J., & Halkitis, P.Publication year
2017Journal title
Journal of LGBT YouthVolume
1410.1080/19361653.2017.1365038Page(s)
436-444The study evaluated the acceptability of text message– and voice-based ecological momentary assessment (EMA) methods among a sample (N = 74) of young men who have sex with men (MSM). We assessed the acceptability of text message– and voice-based EMA methods. Almost all participants (96%) reported that they would be willing to accept texts on their smartphone to answer questions about their current mood, surroundings, or feelings. A large majority (89%) also reported being willing to accept phone calls to answer these questions. This work suggests that different EMA methods are acceptable for use among young MSM.
Associations of Perceived Parental Psychopathology with Mental Health Burden and Lifetime Drug Use in Gay, Bisexual, and other YMSM: The P18 Cohort Study
AbstractHalkitis, P., Griffin-Tomas, M., Levy, M.D., Greene, R.E., & Kapadia, F.Publication year
2017Journal title
Journal of Homosexuality10.1080/00918369.2016.1249734Page(s)
1-21Parental mental health may be a critical component in understanding the overlapping health burdens of mental health symptomatology and drug use in young men who have sex with men (YMSM), yet studies of YMSM have not fully examined these associations. To understand these relationships, data drawn from a study of gay, bisexual, and other YMSM were used to examine associations between perceived parental psychopathology and the health of YMSM. Findings suggest that YMSM reporting at least one parent with perceived depression, manic depression, schizophrenia, or antisocial behavior anytime during their childhoods were more likely to report higher levels of both depressive symptomatology and post-traumatic stress disorder (PTSD) than those reporting no perception of any of these psychopathologies in their parents. Number of different drugs used in one’s life were higher among participants who perceived at least one parent as depressed. Mediation analyses indicated that the relationship between perceived parental depression and lifetime drug use of YMSM was mediated both by YMSM depression and YMSM PTSD. These results suggest that parental psychopathology plays an important role in the health of sexual minority men, a population with elevated levels of mental health burden and drug use across the lifespan.
Latent Growth Curve Modeling of Non-Injection Drug Use and Condomless Sexual Behavior from Ages 18 to 21 in Gay, Bisexual, and Other YMSM: The P18 Cohort Study
AbstractHalkitis, P., Bub, K., Stults, C.B., Bates, F.C., & Kapadia, F.Publication year
2017Journal title
Substance Use and Misuse10.1080/10826084.2017.1334067Page(s)
1-13Background: HIV/AIDS continues to be a health disparity faced by sexual minority men, and is exacerbated by non-injection drug use. Objectives: We sought to delineate growth in non-injection drug use and condomless sex in a sample of racially and economically diverse of gay, bisexual, and other young men who have sex with men (YMSM) as they emerged into adulthood between the ages of 18 and 21 and who came of age in the post-HAART era. Methods: Behavioral data on drug use and condomless sex, collected via a calendar based technique over 7 waves of a cohort study of 600 YMSM, were analyzed using latent growth curve modeling to document patterns of growth in these behaviors, their associations, and the extent to which patterns and associations are moderated by race/ethnicity and socioeconomic status. Results: Significant growth was noted in the frequencies of condomless oral and anal intercourse, alcohol to intoxication, marijuana use, and inhalant nitrate use. High levels of association were noted between all behaviors across time but associations did not differ by either race/ethnicity or socioeconomic status. The link between drug use and risky sexual behavior continue to be evident in YMSM with significant increases in these behaviors demonstrated as YMSM transition between adolescence and young adulthood. Conclusions/Importance: Healthcare for a new generation of sexual minority males must address the synergy of these behaviors and also nest HIV prevention and care within a larger context of sexual minority health that acknowledges the advances made in the last three decades.
Personality and its Relation to Mental and Psychosocial Health in Emerging Adult Sexual Minority Men: The P18 Cohort Study
AbstractD'Avanzo, P.A., Barton, S.C., Kapadia, F., & Halkitis, P.Publication year
2017Journal title
Behavioral MedicineVolume
4310.1080/08964289.2017.1330079Page(s)
191-199Personality disorder and personality pathology encompass a dimension of psychological dysfunction known to severely impact multiple domains of functioning. However, there is a notable dearth of research regarding both the pervasiveness and correlates of personality pathology among young sexual minority males who themselves experience heightened mental health burdens. Using the self-report version of the Standardized Assessment of Personality-Abbreviated Scale we tested associations between distinct personality characteristics with sociodemographic and psychosocial factors as well as mental health states in a sample of 528 young (aged 21–25 years) sexual minority men. In multivariate analysis, personality traits varied significantly by race/ethnicity. Personality traits were also positively associated with psychosocial states, specifically, internalized anti-homosexual bias, level of connection with the gay community, and male body dissatisfaction, as well as mental health in the form of recent depressive and anxious symptomatology. These findings support the complex synergy which exists between personality characteristics, psychosocial conditions, and mental health burdens present among sexual minority men and support the need for an all-encompassing approach to both the study and care of this population that addresses the influences of both internal and external factors on well-being.
Planned parenthood is health care, and health care must defend it: A call to action
Silver, D., & Kapadia, F.Publication year
2017Journal title
American Journal of Public HealthVolume
10710.2105/AJPH.2017.303867Page(s)
1040-1041Preexposure prophylaxis: Adapting HIV prevention models to achieve worldwide access
Landers, S., & Kapadia, F.Publication year
2017Journal title
American Journal of Public HealthVolume
10710.2105/AJPH.2017.304035Page(s)
1534-1535The health of the transgender community: Out, proud, and coming into their own
Landers, S., & Kapadia, F.Publication year
2017Journal title
American Journal of Public HealthVolume
10710.2105/AJPH.2016.303599Page(s)
205-206A case of rectal Ureaplasma infection: molecular testing for STIs may be missing important infections in young men who have sex with men (YMSM): the P18 cohort study
Abbott, C., Greene, R.E., Kapadia, F., & Halkitis, P.Publication year
2016Journal title
LGBT HealthA longitudinal analysis of suicide ideation in emerging adult men who have sex with men
Siconolfi, D.E., Latkin, C., Wilcox, H., Kapadia, F., & Halkitis, P.Publication year
2016Journal title
Archives of Suicide ResearchAssociations Between Neurocognitive Impairment and Biomarkers of Poor Physiologic Reserve in a Clinic-Based Sample of Older Adults Living with HIV
AbstractYu, K.C., D'Avanzo, P.A., Nesheiwat, L., Greene, R.E., Urbina, A., Halkitis, P., & Kapadia, F.Publication year
201610.1016/j.jana.2016.08.007Journal title
Journal of the Association of Nurses in AIDS CareData from a cross-sectional study of a clinic-based sample of older people living with HIV (PLWH; n = 100) were used to examine associations between biomarkers of physical health and neurocognitive impairment (NCI). In this sample, anemia, chronic kidney disease (CKD) stages 4-5, and hypocalcemia were associated with impairment in executive functioning or processing speed. Furthermore, participants with anemia were more likely to have CD4+ T cell counts <200 cells/mm3 (χ2 [1] = 19.57, p < .001); hypocalcemia (χ2 [1] = 17.55, p < .001); and CKD 4-5 (χ2 [2] = 10.12, p = .006). Black and Hispanic participants were more likely to be anemic compared to other races and ethnicities (χ2 [3] = 12.76, p = .005). Common medical conditions (e.g., anemia, hypocalcemia, CKD) should be investigated as potential contributors to NCI in older PLWH. Additionally, laboratory testing in racial/ethnic minority PLWH may help inform NCI screening.
Associations of parental psychopathology with mental health burden and drug use in sexual minority men: the P18 cohort study
Halkitis, P., Griffin-Tomas, M., Kapadia, F., Levy, M., & Greene, R.E.Publication year
2016Journal title
Journal of HomosexualityDemographic, Mental Health, Behavioral, and Psychosocial Factors Associated with Cigarette Smoking Status among Young Men Who Have Sex with Men: The P18 Cohort Study
AbstractD'Avanzo, P.A., Halkitis, P., Yu, K., & Kapadia, F.Publication year
2016Journal title
LGBT HealthVolume
310.1089/lgbt.2015.0128Page(s)
379-386Purpose: Young sexual minority men smoke at higher rates relative to heterosexual peers. The purpose of this study was to examine correlates of smoking in a sample of young gay, bisexual, and other men who have sex with men (MSM) who might differ from more general and age-diverse samples of sexual minority individuals and, thus, inform tailored approaches to addressing tobacco use within this population. Methods: Data on smoking status were examined in relation to demographics, mental health, substance use behavior, and psychosocial factors. Using multinomial logistic regression, factors were identified that differentiate current and former smokers from never smokers. Results: In bivariate analysis, smoking status was related to demographic, mental health, substance use, and psychosocial factors. Most significantly, smoking status was associated with school enrollment status, current alcohol and marijuana use, and symptoms of depression. Multivariate modeling revealed that, compared to being a never smoker, the odds of current or former smoking were highest among those currently using either alcohol or marijuana. The odds of both current and former smoking were also higher among those reporting greater levels of gay community affinity. Finally, the odds of being a former smoker were higher for those reporting internalized antihomosexual prejudice. Conclusion: This study identifies several factors related to smoking status in a diverse sample of young sexual minority males. These findings should encourage investigations of smoking disparities among younger MSM to look beyond common smoking risk factors in an attempt to understand etiologies that may be unique to this group. Such findings may indicate multiple points of potential intervention aimed at decreasing cigarette smoking within this vulnerable population.
Disparities within the Disparity – Determining HIV Risk Factors among Latino Gay and Bisexual Men Attending a Community-Based Clinic in Los Angeles, California
AbstractBeymer, M.R., Weiss, R.E., Halkitis, P., Kapadia, F., Ompad, D., Bourque, L., & Bolan, R.K.Publication year
201610.1097/QAI.0000000000001072Journal title
Journal of Acquired Immune Deficiency SyndromesBACKGROUND:: Latino gay, bisexual, and other men who have sex with men (MSM) in the United States have a 50% greater incidence of HIV when compared to White MSM. Previous studies have analyzed factors contributing to condomless anal intercourse (CAI) among Latino MSM, but few studies have followed cohorts of HIV-negative Latino MSM to determine circumstances for HIV infection. Informed by Syndemics Theory, we examine behavioral, biological, and contextual factors associated with HIV infection for Latino MSM. METHODS:: Risk assessment and HIV testing data were analyzed for all initially HIV-negative, Latino MSM (n = 3,111) visiting a community-based clinic in Los Angeles, California from January 2009 to June 2014. Survival analyses were used to determine characteristics of Latino MSM who became HIV-positive during the study timeframe. RESULTS:: Similar to previous studies of MSM, self-reported history of Chlamydia, Gonorrhea and/or Syphilis (aHR: 1.97; CI: 1.28-3.04), receptive CAI (aHR: 1.7; CI: 1.16-2.49), and methamphetamine use (aHR: 1.99; CI: 1.15-3.43) predicted HIV infection. In addition, originating from Central America (aHR: 2.31; CI: 1.41-3.79), Latino ethnicity of the last sex partner (aHR: 1.67; CI: 1.16-2.39), and experiencing intimate partner violence (IPV) (aHR: 1.73; CI: 1.13-2.64) were also associated with HIV infection among Latino MSM. CONCLUSIONS:: This is the first study to show independent associations between IPV and HIV infection among Latino MSM. This study shows that psychosocial conditions such as IPV fuel HIV incidence among Latino MSM, and psychosocial interventions should be considered to reduce HIV disparities among Latino MSM.
Drug use among HIV+ adults aged 50 and older: findings from the GOLD II study
AbstractOmpad, D., Giobazolia, T.T., Barton, S.C., Halkitis, S.N., Boone, C.A., Halkitis, P., … Urbina, A.Publication year
2016Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV10.1080/09540121.2016.1178704Page(s)
1-5Understanding the nexus of aging, HIV, and substance use is key to providing appropriate services and support for their aging, HIV seropositive patients. The proportion of PLWHA aged 50 and older is growing due to a variety of factors like decreases in mortality due to highly active retroviral therapy and non-negligible HIV incidence. We describe prevalence of alcohol, tobacco, and other drug use and participation in substance use treatment and 12-step programs among 95 HIV-positive patients aged 50 and older engaged in care. Most (73.7%) smoked cigarettes in their lifetime and 46.3% were current smokers. Most were at medium (81.1%) or high risk (13.7%) for an alcohol use disorder. With respect to illicit drug use, 48.4% had used marijuana, cocaine, crack, methamphetamines, heroin, and/or prescription opiates without a prescription in the last 12 months; 23.2% met criteria for drug dependence. Marijuana was the most commonly reported illicit drug (32.6%) followed by cocaine and crack (10.5% each), heroin and prescription opiates (7.4% each), and methamphetamines (6.3%). Among those who had not used drugs in the past 12 months, 36.7% had been in a substance use treatment program and 26.5% had participated in a 12-step program in their lifetime; 8.2% were currently in treatment and 16.3% were currently participating in a 12-step program. Among those who had used an illicit drug in the past 12 months, 37.0% had never been in treatment, 34.8% had been in treatment in their lifetime, and 28.3% were currently in treatment. With respect to 12-step programs, 27.3% of those meeting dependence criteria had never participated, 45.5% had participated in their lifetimes, and 27.3% were currently participating. Our findings suggest that older adults in HIV care settings could benefit from Screening, Brief Intervention, and Referral to Treatment interventions and/or integrated services for substance abuse and medical treatment.
Early Life Psychosocial Stressors and Housing Instability among Young Sexual Minority Men: the P18 Cohort Study
AbstractKrause, K.D., Kapadia, F., Ompad, D., D’Avanzo, P.A., Duncan, D.T., & Halkitis, P.Publication year
2016Journal title
Journal of Urban Health10.1007/s11524-016-0049-6Page(s)
1-15Homelessness and housing instability is a significant public health problem among young sexual minority men. While there is a growing body of literature on correlates of homelessness among sexual minority men, there is a lack of literature parsing the different facets of housing instability. The present study examines factors associated with both living and sleeping in unstable housing among n = 600 sexual minority men (ages 18–19). Multivariate models were constructed to examine the extent to which sociodemographic, interpersonal, and behavioral factors as well as adverse childhood experiences explain housing instability. Overall, 13 % of participants reported sleeping in unstable housing and 18 % had lived in unstable housing at some point in the 6 months preceding the assessment. The odds of currently sleeping in unstable housing were greater among those who experienced more frequent lack of basic needs (food, proper hygiene, clothing) during their childhoods. More frequent experiences of childhood physical abuse and a history of arrest were associated with currently living in unstable housing. Current enrollment in school was a protective factor with both living and sleeping in unstable housing. These findings indicate that being unstably housed can be rooted in early life experiences and suggest a point of intervention that may prevent unstable housing among sexual minority men.
Feasibility and acceptability of global positioning system (GPS) Methods to study the spatial contexts of substance use and sexual risk behaviors among young men who have sex with men in New York City: A P18 cohort sub-study
AbstractDuncan, D.T., Kapadia, F., Regan, S.D., Goedel, W.C., Levy, M.D., Barton, S.C., … Halkitis, P.Publication year
2016Journal title
PLoS One10.1371/journal.pone.0147520Volume
11Background No global positioning system (GPS) technology study has been conducted among a sample of young gay, bisexual, and other men who have sex with men (YMSM). As such, the purpose of this study was to evaluate the feasibility and acceptability of using GPS methods to understand the spatial context of substance use and sexual risk behaviors among a sample of YMSM in New York City, a high-risk population. Methods Data came from a subsample of the ongoing P18 Cohort Study (n = 75). GPS feasibility and acceptability among participants was measured with: 1) a pre-and post-survey and 2) adherence to the GPS protocol which included returning the GPS device, self-report of charging and carrying the GPS device as well as objective data analyzed from the GPS devices. Analyses of the feasibility surveys were treated as repeated measures as each participant had a pre-and post-feasibility survey. When comparing the similar GPS survey items asked at baseline and at follow-up, we present percentages and associated p-values based on chi-square statistics. Results Participants reported high ratings of pre-GPS acceptability, ease of use, and low levels of wear-related concerns in addition to few concerns related to safety, loss, or appearance, which were maintained after baseline GPS feasibility data collection. The GPS return rate was 100%. Most participants charged and carried the GPS device on most days. Of the total of 75 participants with GPS data, 75 (100%) have at least one hour of GPS data for one day and 63 (84%) had at least one hour on all 7 days. Conclusions Results from this pilot study demonstrate that utilizing GPS methods among YMSM is feasible and acceptable. GPS devices may be used in spatial epidemiology research in YMSM populations to understand place-based determinants of health such as substance use and sexual risk behaviors.
Intimate Partner Violence and Sex Among Young Men Who Have Sex With Men
AbstractStults, C.B., Javdani, S., Greenbaum, C.A., Kapadia, F., & Halkitis, P.Publication year
2016Journal title
Journal of Adolescent HealthVolume
5810.1016/j.jadohealth.2015.10.008Page(s)
215-22PURPOSE: Among young men who have sex with men (YMSM) few studies have examined the relationship between intimate partner violence (IPV) perpetration versus victimization and sexual behaviors.
METHODS: Using data from n = 528 urban YMSM, multinomial logistic regression models were built to examine the distinct relationships between any IPV, victimization, and perpetration with condomless sex in the previous 30 days, controlling for key sociodemographic characteristics.
RESULTS: In this sample of YMSM, lifetime experience of any IPV was associated with increased odds of recent condomless oral (adjusted odds ratio [AOR] = 1.81, 95% confidence interval [CI] = 1.21-2.72) and anal receptive sex (AOR= 2.29, 95% CI = 1.22-4.31). IPV victimization was associated with a greater likelihood of condomless receptive anal sex (AOR= 2.12, 95% CI = 1.15-3.93) whereas IPV perpetration was associated with increased odds of condomless receptive (AOR= 2.11, 95% CI = 1.14-3.91) and insertive (AOR= 2.21, 95% CI = 1.06-4.59) anal sex.
CONCLUSIONS: Among YMSM, reports of both IPV perpetration and victimization were associated with increased odds of recent condomless sex. These findings indicate that the need for IPV prevention and intervention programs for this new generation of YMSM is highly warranted.
Neurocognitive functioning in an urban clinic-based sample of adults ages 50 and older living with HIV
AbstractHalkitis, P., D’Avanzo, P.A., Stults, C.B., Levy, M.D., Krause, K.D., Kupprat, S.A., … Kapadia, F.Publication year
2016Journal title
Journal of HIV/AIDS and Social Services10.1080/15381501.2016.1224748Page(s)
1-22We administered a battery of neurocognitive tests to 100 HIV-positive men and women ages 50 to 70 seeking care at a large Northeastern urban HIV care clinic. Performance on neurocognitive assessments varied by demographic states. Across all assessments, approximately 28% of participants reached the threshold for borderline performance while 13% reached the threshold for impairment. When tests were grouped by domain of neurocognitive functioning, 12% of the sample met the threshold for impairment on executive functioning and 19% for processing speed. The findings demonstrate that neurocognitive declines may vary by domains of functioning, that disparities may exist across subpopulations of the seropositive aging population, and that these challenges may exist even in those actively engaged in HIV care.
Perceived social support and mental health states in a clinic-based sample of older HIV positive adults
AbstractKapadia, F., Levy, M., Griffin-Tomas, M., Greene, R.E., Halkitis, S.N., Urbina, A., & Halkitis, P.Publication year
2016Journal title
Journal of HIV/AIDS and Social Services10.1080/15381501.2016.1212295Page(s)
1-11Despite a high prevalence of mental health problems in older, HIV+ adults (aged ≥ 50), few studies have examined the relationship between perceived social support and mental health burdens in this group. In a clinic-based sample of 100 adults, 23% and 29% met criteria for one and more than one mental health burden, respectively. In multivariable binary logistic models, perceived receipt of positive and emotional social support as well as overall support was inversely associated with the presence of mental health burdens. There is a need for additional investigation of how social support can help mitigate mental health burdens among HIV+ older adults.
Prosocial factors and self-rated health among young sexual minority males: the P18 Cohort Study
Kapadia, F., D'Avanzo, P.A., Barton, S., Halkitis, S.N., & Halkitis, P.Publication year
2016Journal title
Journal of Adult DevelopmentRelationship cognitions and longitudinal trajectories of sexual risk behavior among young gay and bisexual men: The P18 cohort study
Cook, S., Halkitis, P., & Kapadia, F.Publication year
201610.1177/1359105316671187Journal title
Journal of Health PsychologyReliability and Validity of a Material Resources Scale and Its Association With Depression Among Young Men Who Have Sex With Men: The P18 Cohort Study
AbstractOmpad, D., Palamar, J.J., Krause, K.D., Kapadia, F., & Halkitis, P.Publication year
201610.1177/1557988316651206Journal title
American Journal of Men's HealthSocioeconomic status (SES) is a fundamental cause of ill health, but an understudied determinant of health for gay, bisexual, and other men who have sex with men (MSM). Surprisingly, few studies have examined the relations between poverty and depression among young MSM. The aims of this study were to determine the reliability and validity of an 18-item Family Resource Scale (FRS) as a measure of SES among YMSM and examine the relations between SES and depression, while taking into account factors associated with resilience or risk for poor mental health. Reliability of the SES scale was determined with Cronbach's alpha. Validity was assessed with factor analysis and bivariable comparisons with other SES measures. Multiple logistic regression was used to determine the relations between depressive symptomology (via the Beck Depression Inventory-II), SES, and gay-related psychosocial variables. In this racially/ethnically diverse sample (mean age = 21.8 years, 37.3% Hispanic/Latino, 30.5% White, 14.9% Black, and 17.0% other race/ethnicity), 70.8% reported incomes ≤ $10,000 and the mean FRS score was 4.1 (SD = 0.9, range 0-5). The FRS demonstrated reliability (α = .91) and criterion and construct validity. The Beck Depression Inventory-II rated 17.6% with depressive symptomology. Higher FRS scores were associated with a lower odds of depression (adjusted odds ratio = 0.58; 95% confidence interval = 0.46-0.74) in logistic regression models controlling for gay community affinity and internalized homophobia. This diverse sample of YMSM in New York City reported substantial financial hardship and those who were more gay-identified had fewer material resources. Fewer material resources and internalized homophobia were both associated with higher odds of depression.
Social support as an effect modifier of the relationship between sexual violence and transactional sex among female, foreign migrants in Cape Town, South Africa
Giorgio, M., Townsend, L., Zembe, Y., Cheyip, M., Guttmacher, S., Kapadia, F., & Matthews, C.Publication year
2016Journal title
American Journal of Public HealthVolume
106Social support, sexual violence, and transactional sex among female transnational migrants to South Africa
AbstractGiorgio, M., Townsend, L., Zembe, Y., Guttmacher, S., Kapadia, F., Cheyip, M., & Mathews, C.Publication year
2016Journal title
American Journal of Public HealthVolume
10610.2105/AJPH.2016.303107Page(s)
1123-1129Objectives. To examine the relationship between sexual violence and transactional sex and assess the impact of social support on this relationship among female transnational migrants in Cape Town, South Africa. Methods. In 2012 we administered a behavioral risk factor survey using respondentdriven sampling to transnational migrant women aged between 16 and 39 years, born outside South Africa, living in Cape Town, and speaking English, Shona, Swahili, Lingala, Kirundi, Kinyarwanda, French, or Somali. Results. Controlling for study covariates, travel-phase sexual violence was positively associated with engagement in transactional sex (adjusted prevalence ratio [APR] = 1.38; 95% confidence interval [CI] = 1.07, 1.77), and social support was shown to be a protective factor (APR = 0.84; 95% CI = 0.75, 0.95). The interaction of experienced sexual violence during migration and social support score was APR = 0.85 (95% CI = 0.66, 1.10). In the stratified analysis, we found an increased risk of transactional sex among the low social support group (APR = 1.56; 95% CI = 1.22, 2.00). This relationship was not statistically significant among the moderateor high social support group (APR = 1.04; 95% CI = 0.58, 1.87). Conclusions. Programs designed to strengthen social support may reduce transactional sex among migrant women after they have settled in their receiving communities.