Investigation, Development and Integral Education Association, Quetzaltenango, Guatemala.
Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA.
AIDS Behav. 2018 Jul;22(Suppl 1):45-56. doi: 10.1007/s10461-018-2190-6.
Guatemala has a concentrated HIV epidemic disproportionately affecting men who have sex with men (MSM) and transgender women. We recruited 205 self-identified MSM, bisexuals, transvestites, and transgender women in western Guatemala using long-chain peer referral, wherein "seed" participants were asked to invite as many as three acquaintances to participate in the study. Self-reported sexual or gender identity was MSM, 46%; bisexual, 28%; transvestite, 21%, and transgender woman, 5%. Median age of the participants was 23 years, and 36% self-identified as being indigenous. Indigenous persons were more likely to self-identity as transvestite (32.9% vs 13.8%, P = 0.04), strongly perceive themselves at risk for HIV (87.7% vs 51.5%, P = 0.001), have had an HIV test in the last 12 months and know the result (97.3% vs 85.4%, P = 0.008), and experience barriers to testing and treatment (86.3% vs 67.7%, P = 0.004). HIV prevention services for indigenous MSM should especially target transvestites and how to overcome stigmatization and barriers to care.
危地马拉的艾滋病毒疫情集中在男男性行为者（MSM）和跨性别女性群体中，这一群体受到了不成比例的影响。我们在危地马拉西部招募了 205 名自认为是 MSM、双性恋者、易装癖者和跨性别女性的人，使用长链同侪推荐法，即“种子”参与者被要求邀请多达三个熟人参与研究。自我报告的性或性别认同为 MSM，占 46%；双性恋者，占 28%；易装癖者，占 21%；跨性别女性，占 5%。参与者的中位数年龄为 23 岁，36%的人自认为是土著人。土著人更有可能自我认同为易装癖者（32.9%比 13.8%，P=0.04），强烈认为自己有感染艾滋病毒的风险（87.7%比 51.5%，P=0.001），在过去 12 个月内接受过艾滋病毒检测并知晓检测结果（97.3%比 85.4%，P=0.008），并经历了检测和治疗的障碍（86.3%比 67.7%，P=0.004）。针对土著 MSM 的艾滋病毒预防服务应特别针对易装癖者，并探讨如何克服污名化和护理障碍。
