Sexually Transmitted Infections and Risk Behaviors Among Transgender Persons (Hijras) of Pune, India
Adult
Male
Sexual Behavior
Sexually Transmitted Diseases
India
HIV Infections
3. Good health
Young Adult
03 medical and health sciences
Cross-Sectional Studies
Risk-Taking
0302 clinical medicine
5. Gender equality
Risk Factors
Surveys and Questionnaires
Prevalence
Humans
Homosexuality, Male
Heterosexuality
10. No inequality
Transsexualism
DOI:
10.1097/qai.0b013e318236bd6f
Publication Date:
2011-10-04T19:46:03Z
AUTHORS (11)
ABSTRACT
The objectives of this cross-sectional study were to determine the prevalence of HIV and sexually transmitted infections (STI) in Hijras (self-identified transgenders of South Asia), study associated risk factors, and compare the prevalence with that in heterosexual men and men having sex with men (MSM) in Pune, India, between 1993 and 2002.After informed consent, individuals attending 3 STI clinics were administered a questionnaire regarding their demographic, socioeconomic, and sexual behaviors. Blood samples were collected for STI and HIV diagnosis. Bivariate and multivariate analyses were performed to determine the correlates of HIV infection.The prevalence of HIV (45.2% in Hijras vs 20% in heterosexual men vs 18.9% in MSM, P < 0.0001) and warts (10.3% vs 4.6% vs 7.0%; P = 0.004) was higher in Hijras as compared with heterosexual men and MSM; whereas that of genital ulcer disease (15.3% vs 32.6% vs 21.5%; P < 0.0001) and discharge (5.4% vs 13.6% vs 9.0%; P < 0.0001) was lower. Hijras were more likely to have received money for sex and have an earlier sexual debut than the comparison groups. In multivariate analysis, receiving money for sex (adjusted odds ratio: 4.49; P < 0.04) and having genital ulcer disease (odds ratio: 3.87; P < 0.08) were independently associated with high HIV prevalence in Hijras.Considering the high HIV and STI burden, it is important to review current prevention strategies and stress the need to engage Hijra community members through appropriate targeted intervention programs.
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