Harawa Nina T, Bingham Trista A
Charles Drew University of Medicine and Science, Los Angeles, CA, USA.
AIDS Educ Prev. 2009 Aug;21(4):356-71. doi: 10.1521/aeap.2009.21.4.356.
Female sex worker (FSW) and male-to-female transgender (TGW, transgender women) populations both experience elevated levels of HIV infection and have unique prevention needs because of their stigmatized social status and often-precarious economic circumstances. We analyzed data from 104 FSWs and 128 TGW to assess their level of exposure to active and passive HIV prevention services and identify which subgroups are underserved. Data were collected, in Los Angeles for the cross-sectional 2003-2004 HIV Testing Survey (HITS), through face-to-face interviews with participants recruited primarily from street, club, and social service venues. Both groups reported more passive than active prevention exposure, with overall participation less common for FSWs than for TGW. Although some differences were observed between groups, predictors of lower HIV prevention utilization identified in both study populations included African American (versus Hispanic) race/ethnicity, higher household incomes, cohabitation/marriage, and not seeking recent health care. Prevention efforts should increase outreach to these subgroups, tailor programs for those who are African American or partnered, and increase the proportion of FSWs and TGW who periodically engage in active HIV prevention services such as client-centered counseling and small-group interventions to build skills related to safer sex.
女性性工作者（FSW）和男变女跨性别者（TGW，跨性别女性）群体都面临着较高的艾滋病毒感染率，由于他们受到污名化的社会地位以及往往不稳定的经济状况，他们有着独特的预防需求。我们分析了104名女性性工作者和128名男变女跨性别者的数据，以评估他们接受主动和被动艾滋病毒预防服务的程度，并确定哪些亚群体未得到充分服务。数据是在洛杉矶通过对主要从街头、俱乐部和社会服务场所招募的参与者进行面对面访谈收集的，用于2003 - 2004年的横断面艾滋病毒检测调查（HITS）。两组都报告称被动预防接触比主动预防接触更多，女性性工作者的总体参与度比男变女跨性别者更低。尽管两组之间观察到了一些差异，但在两个研究群体中确定的艾滋病毒预防利用率较低的预测因素包括非裔美国人（与西班牙裔相比）种族/族裔、较高的家庭收入、同居/婚姻以及近期未寻求医疗保健。预防工作应加强对这些亚群体的外展服务，为非裔美国人或有伴侣的人量身定制项目，并提高女性性工作者和男变女跨性别者中定期参与主动艾滋病毒预防服务（如以客户为中心的咨询和小组干预以培养与安全性行为相关技能）的比例。
