Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
Sex Transm Infect. 2019 Feb;95(1):46-52. doi: 10.1136/sextrans-2018-053653. Epub 2018 Jun 27.
All males and females attending the Melbourne Sexual Health Centre (MSHC) from August 2017 were asked whether they had had sex with a transgender or gender diverse (TGD) person using computer-assisted self-interviewing (CASI). We aimed to verify the self-reported responses via chart review. The secondary aim of this study was to identify whether having sex with a TGD person was associated with STI risk.
This was a retrospective chart analysis of patients visiting MSHC between August and December 2017. Chart review was performed to verify the self-reported responses. Multivariable logistic regression was performed to examine the association between having sex with a TGD person and patients' characteristics and STI risk.
Of the 10 100 male and female consultations, the proportion who reported having sex with a TGD person was 111 (1.0%) and was higher among males (1.3%) than females (0.6%) (p=0.001). After chart review, we could verify 66.9% of the responses, more for males (75.2%) than females (45.2%) (p<0.001). Of the 6822 males, men aged ≥35 years (adjusted OR=2.2; 95% CI 1.1 to 4.1) were more likely to have sex with a TGD person compared with men aged ≤24 years, after adjusting for confounding factors. Sex with a TGD person was not associated with sexual orientation in males. Of the 3278 females, gay and bisexual females had 13.7-fold (95% CI 5.1 to 37.0) higher odds of having sex with a TGD person than heterosexual females. There was no association between chlamydia positivity and sex with a TGD person in both males and females.
When a question on TGD partners is asked as part of routine sexual history using CASI, the majority of responses could be verified. TGD partners were most commonly reported among males. These findings underscore the value of asking patients about sex with TGD partners.
2017 年 8 月起，所有在墨尔本性健康中心（MSHC）就诊的男性和女性都被要求使用计算机辅助自访谈（CASI）回答他们是否与跨性别或性别多样化（TGD）者发生过性行为。我们旨在通过病历回顾来验证自我报告的结果。本研究的次要目的是确定与 TGD 者发生性行为是否与性传播感染（STI）风险相关。
这是对 2017 年 8 月至 12 月期间在 MSHC 就诊的患者进行的回顾性病历分析。通过病历回顾来验证自我报告的结果。采用多变量逻辑回归来检查与 TGD 者发生性行为与患者特征和 STI 风险之间的关联。
在 10100 名男性和女性就诊者中，报告与 TGD 者发生性行为的比例为 111 例（1.0%），男性（1.3%）高于女性（0.6%）（p=0.001）。经病历审查后，我们可以验证 66.9%的答复，其中男性的验证比例（75.2%）高于女性（45.2%）（p<0.001）。在 6822 名男性中，与 24 岁以下的男性相比，年龄≥35 岁的男性（调整后的 OR=2.2；95%CI 1.1 至 4.1）更有可能与 TGD 者发生性行为，调整混杂因素后结果一致。与性取向相比，男性与 TGD 者发生性行为与性取向无关。在 3278 名女性中，同性恋和双性恋女性与异性恋女性相比，与 TGD 者发生性行为的可能性高 13.7 倍（95%CI 5.1 至 37.0）。在男性和女性中，衣原体阳性与与 TGD 者发生性行为均无关联。
当使用 CASI 作为常规性病史的一部分询问 TGD 伴侣问题时，大多数回答都可以得到验证。TGD 伴侣在男性中最常见。这些发现强调了询问患者与 TGD 伴侣发生性行为的重要性。
