High HIV prevalence and associated risk factors among transgender women in China: a cross‐sectional survey

Abstract

Introduction Transgender women may face the highest prevalence of HIV of any population, experiencing a disproportionate burden of disease frequently confirmed in surveys throughout the developing and developed world. However, few studies have been conducted specifically for transgender women in China. This study aimed to measure HIV prevalence and explore risk factors for infection in a diverse sample of Chinese transgender women to help advocate for prevention and care interventions for this population. Methods From July 2018 to May 2019, we adapted a respondent‐driven sampling (RDS) approach to recruit a diverse sample of 250 transgender women through chains of peer referrals in two cities of eastern China, Nanjing and Suzhou. Eligible participants (i.e. 18 years of age or older, living in Jiangsu province and assigned male sex at birth but currently self‐identified as a gender different from male) completed a self‐administered questionnaire on a mobile phone to collect demographic characteristics and risk behaviours and underwent HIV testing. Results and discussion The survey sample was young (82% under age 35 years), with 28.8% having a university degree, 39.2% reporting work at entertainment venues, 47.6% ever having taken hormones and 6.4% being diagnosed with an STI in the last year. One in five (20.8%) reported having engaged in sex work. HIV prevalence was 14.8% (95% CI 10.6 to 19.8), with 75.6% of those testing HIV positive reporting they were already aware of their serostatus. In multivariate analysis, HIV prevalence was significantly higher among transgender women above the age of 24 years, those who work at entertainment venues, who never have taken hormones, and who had been diagnosed with an STI in the last year. Conclusions The prevalence of HIV among transgender women in our study, at 14.8%, is among the highest detected in any population in eastern China. Chinese transgender women may therefore follow the disparity in the burden of HIV noted worldwide. Data support policies to prioritize transgender women for HIV testing outreach, for in‐depth research to better understand the specific drivers of infection in this population, and for trans‐friendly HIV care and prevention programmes to address their specific needs.

HIV Prevalence and Factors Related to HIV Infection Among Transgender Women in Vietnam: A Respondent Driven Sampling Approach

“…This study revealed an HIV prevalence of 16.5% among TGW in Ho Chi Minh City. This prevalence was higher than the findings from other countries, including Cambodia (5.9%) [19], China (14.8%) [20] and Malaysia (11.7%) [6]. This observed prevalence highlights the high risk for HIV infection among transgender women in Vietnam and was consistent with global literature regarding the high burden of HIV infection among the transgender population [5].…”

Uso de hormônios não prescritos na modificação corporal de travestis e mulheres transexuais de Salvador/Bahia, Brasil

“…A explicação proposta pelos autores foi: as mulheres transexuais que não desejavam os efeitos feminizadores dos hormônios ou não podiam pagar por ele eram vistas como transgressoras das normas de gênero pelas comunidades trans e cisgênero, tornandose mais vulneráveis, e portanto com maior risco, à infecção por HIV. Outro ponto tratado no estudo é que as mulheres trans que praticam mais sexo não fazem uso de hormônios para não terem a libido diminuída, o que aumenta o risco de infecções sexualmente transmissíveis 47 .…”

HIV incidence and risk factors among transgender women and cisgender men who have sex with men in two cities of China: a prospective cohort study

“…However, as transgender women are often hidden and their gender identity data usually could not be collected completely or consistently, current related research is still limited. And despite three studies reporting a prevalence of 7.6%–14.8% among Chinese transgender women [ 2 , 17 , 18 ], they were primarily cross-sectional design, either with small sample size or provide little information on their differences within the broad category “MSM”. It is known that HIV incidence could well reflect HIV epidemic trend as well as the effect of HIV prevention and control efforts.…”