中国 transgender 人群的性行为与艾滋病毒/梅毒检测：对扩大艾滋病毒检测服务的启示
Sexual behaviors and HIV/syphilis testing among transgender individuals in China: implications for expanding HIV testing services.
作者信息
Best John, Tang Weiming, Zhang Ye, Han Larry, Liu Fengying, Huang Shujie, Yang Bin, Wei Chongyi, Tucker Joseph D
机构信息
From the *University of North Carolina Project-China Office, Guangzhou, China; †Department of Medicine, Medical School, University of California-San Francisco, San Francisco, CA; ‡STD Control Department, Guangdong Provincial Center for Skin Diseases and STI Control & Prevention, Guangzhou, China; §Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; and ¶Department of Epidemiology and Biostatistics & Global Health, University of California-San Francisco, San Francisco, CA.
出版信息
Sex Transm Dis. 2015 May;42(5):281-5. doi: 10.1097/OLQ.0000000000000269.
BACKGROUND
HIV and syphilis are disproportionately common among transgender individuals globally, yet few studies have investigated transgender HIV/syphilis risk and testing in low- and middle-income nations. We conducted an online survey of men who have sex with men (MSM) and transgender individuals to examine sexual behaviors and HIV/syphilis testing in China.
METHODS
We recruited MSM and transgender individuals from 2 major Chinese lesbian, gay, bisexual, and transgender Web platforms. χ Test and logistic regression were used to compare risk behaviors, HIV and syphilis testing history, and prevalence between transgender individuals and other MSM.
RESULTS
Among the 1320 participants, 52 (3.9%) self-identified as transgender. Demographics, including education, employment, and marital status, were similar between both groups, whereas transgender individuals were older. Condomless anal intercourse rate was comparable between the groups. Transgender individuals were less likely to report ever testing for HIV (34.6% vs. 62.0%) and syphilis (15.7% vs. 31.2%) with adjusted odds ratios of 0.36 (95% confidence interval, 0.20-0.65) and 0.42 (95% confidence interval, 0.20-0.91), respectively. We found a trend toward a higher HIV prevalence among transgender individuals (11.1% vs. 5.7%, P = 0.12).
CONCLUSIONS
Transgender individuals have suboptimal HIV and syphilis testing rates in China. Given the substantial risk behaviors and burden of HIV/STI in the general Chinese MSM population and a lack of knowledge about transgender individuals, enhanced HIV/syphilis testing programs for transgender individuals in China are needed.
背景
在全球范围内，艾滋病毒和梅毒在跨性别者中极为常见，但在低收入和中等收入国家，很少有研究调查跨性别者感染艾滋病毒/梅毒的风险及检测情况。我们针对男男性行为者（MSM）和跨性别者开展了一项在线调查，以研究中国的性行为及艾滋病毒/梅毒检测情况。
方法
我们从中国两个主要的女同性恋、男同性恋、双性恋和跨性别者网络平台招募了男男性行为者和跨性别者。采用χ检验和逻辑回归来比较跨性别者与其他男男性行为者之间的风险行为、艾滋病毒和梅毒检测史以及患病率。
结果
在1320名参与者中，52人（3.9%）自我认定为跨性别者。两组的人口统计学特征，包括教育程度、就业情况和婚姻状况相似，但跨性别者年龄更大。两组间无保护肛交率相当。跨性别者报告曾经进行艾滋病毒检测（34.6%对62.0%）和梅毒检测（15.7%对31.2%）的可能性较小，调整后的优势比分别为0.36（95%置信区间，0.20 - 0.65）和0.42（95%置信区间，0.20 - 0.91）。我们发现跨性别者中艾滋病毒患病率有升高趋势（11.1%对5.7%，P = 0.12）。
结论
在中国，跨性别者的艾滋病毒和梅毒检测率不理想。鉴于中国男男性行为者总体存在大量风险行为及艾滋病毒/性传播感染负担，且对跨性别者缺乏了解，中国需要加强针对跨性别者的艾滋病毒/梅毒检测项目。
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