A study of six US cities found a high prevalence of bacterial sexually transmitted infections (STIs) in transgender women (TGW), particularly those with HIV, researchers reported today in the Journal of Infectious Diseases.
Using baseline data from the Leading Innovation for Transgender Women's Health and Empowerment study, which examined HIV incidence and other health outcomes in TGW in six southeastern and eastern US cities (Atlanta, Baltimore, Boston, Miami, New York, and Washington, DC), a team led by researchers from Johns Hopkins Bloomberg School of Public Health analyzed bacterial STI test results from 1,018 participants. The primary outcome was the prevalence of at least one bacterial STI (gonorrhea, chlamydia, or syphilis) at any anatomic site.
Prevalence higher in those with HIV
The median age of participants was 29 years, 29% were Black, 27% were Hispanic, and 27% had HIV. The overall prevalence of any bacterial STI was 16% but was threefold higher in TGW with HIV (32% vs 11% among those without HIV). After adjustments for age, race and ethnicity, and region, HIV infection remained significantly associated with any bacterial STI (adjusted prevalence ratio, 1.9; 95% confidence interval, 1.39 to 2.62).
Among TGW without HIV, bacterial STI prevalence differed by geographic region, race and ethnicity, and gender identity, and was positively associated with reporting more than 1 sexual partner, hazardous alcohol use, homelessness, having safety concerns regarding transit to healthcare, and no prior receipt of gender-affirming health services. Among TGW with HIV, older age was inversely associated with bacterial STI.
...the variation in bacterial STI prevalence and correlates seen between TGW with and without HIV highlights the differential burden and needs of these two populations
The study authors say the findings underscore the need to develop interventions that are tailored to the unique needs and risks of each population.
"Although participants with and without HIV had a high prevalence of bacterial STIs, the variation in bacterial STI prevalence and correlates seen between TGW with and without HIV highlights the differential burden and needs of these two populations," they wrote. "Elucidating the ways in which situated vulnerabilities are associated with STI risk may help inform more tailored intervention strategies for each population."