Amsterdam 2015
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| Abstract #2225 - Trans people - rights and services | ||||
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Session: 54.2: Trans people - rights and services (Parallel) on Friday @ 11.00-12.30 in 202 Chaired by Pum Kommattam, Jose Bauermeister Authors: Presenting Author: Prof Joseph Tak Fai Lau - The Chinese University of Hong Kong, Hong Kong |
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| Additional Authors: Dr Berthbsp;yssouf, Mme Fatoumata ouattara, Mlle Koua Tagna, | ||||
| Aim: Transgender women who are sex workers serving men (TG-FSW) are at high risk of HIV/STD transmission. A sizeable population of TG women in China engaged in transactional sex serving men in feminine dressing. There is a dearth of studies on their HIV prevalence and sexual risk behaviors. The present study is to investigate: 1) prevalence of self-reported or tested HIV status and unprotected anal intercourse (UAI) with male clients in the last month among TG-FSW and 2) multi-dimensional associated factors including background characteristics, variables related to TG activities and transactional sex, cognitive variables related to HIV and condom use, as well as psycho-social variables. | ||||
| Method / Issue: The inclusion criteria were: 1) self-reported gender identity as a transgender or transsexual woman (pre- or postoperative), 2) aged over 18 years old, 3) having had anal intercourse with at least one male client in the last three months and 4) feminine dressing during transactional sex with men. 220 participants were recruited with the help of an NGO. Appointments were made for an anonymous face-to-face interview conducted by trained NGO staff in settings with privacy ensured. A total of 183 participants self-reported to be HIV negative or of unknown HIV sero-status were invited to take up HIV testing and counseling 49.2% voluntarily took it up as a result. | ||||
| Results / Comments: Among all participants, prevalence of self-reported HIV positive status was 16.8% prevalence of self-reported or tested being HIV positive was 25.9%. Prevalence of UAI with male clients in the last month was 26.8%. Adjusted for significant background variables (highest educational level attained, HIV prevention service utilization in the last six months, self-reported or tested HIV sero-status), factors positively associated with UAI with male clients in the last month included: 1) higher number of TG actions such as breast augmentation and estrogen hormone replacement treatment (Adjusted odds ratio (AOR) = 1.40), 2) recruiting clients mainly in hotels (AOR = 5.02, reference group: via internet), 3) perception that feminine dressing would increase chance of UAI with male clients (AOR=1.95), 4) perceptions that one would increase UAI to hide TG status from male clients during transactional sex (AOR=1.17), 5) depression assessed by CESD-20 (AOR=1.04), 6) UCLA Loneliness Scale (AOR=1.08) and 7) suicidal ideation in the last year (AOR=2.86). Factors negatively associated with UAI with male clients in the last month included: 1) cost per episode of transactional sex with men (32 to 64 USD: AOR = 0.27, reference group: < 16 USD), 2) perceived self-efficacy in condom use with male clients (AOR = 0.56), and 3) Ronsenberg Self Esteem Scale score (AOR=0.85). | ||||
| Discussion: Prevalence of HIV and UAI with male clients was high among TG-FSW in China. Interventions are warranted but lacking. TG behaviors increased risk of UAI. It is important to reduce psychological problems such as depression and self-esteem, which were highly associated with UAI. Attention should be paid to those who charged lowly for their sex service. It is also important to improve self-efficacy in condom use among TG-FSW. | ||||
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