Department of Epidemiology, University of Washington, Seattle, WA.
Asociación Vía Libre, Lima, Perú.
J Acquir Immune Defic Syndr. 2019 Apr 15;80(5):522-526. doi: 10.1097/QAI.0000000000001966.
Transgender women (TW) and men who have sex with men (MSM) are often conflated in HIV research and prevention programs, despite clear differences that exist in culture and behavior.
We examined baseline data from a large treatment-as-prevention study among TW and MSM in Lima, Peru, to assess differences in risk behavior. Baseline assessment included HIV testing and a questionnaire including sociodemographics, sexual behavior, social venue attendance, and drug and alcohol use. Poisson regression with robust standard errors was used to calculate prevalence ratios adjusted for confounding variables [adjusted prevalence ratio (aPR)] and 95% confidence intervals (CIs) comparing the prevalence of covariates related to HIV risk in MSM and TW.
Overall, 310 TW and 2807 MSM participated between July 2013 and September 2015 and were included in this analysis. TW engaged in some protective sexual health practices more than MSM, including HIV testing in the last year (aPR = 1.62; 95% CI: 1.42 to 1.84) and condom use at the last sexual encounter (aPR = 1.20; 95% CI: 1.06 to 1.36). TW were more likely to have sex while using alcohol (aPR 1.15, 95% CI: 1.01 to 1.31) or drugs (aPR 2.24, 95% CI: 1.47 to 3.41), have alcohol dependency (aPR 1.38, 95% CI: 1.15 to 1.66), engage in receptive anal sex (aPR 1.31, 95% CI: 1.26 to 1.36), and have received money, gifts, or favors in exchange of anal sex (1.96, 95% CI: 1.74 to 2.20).
TW and MSM exhibited distinct risk profiles, suggesting that interventions specifically targeted to each group may provide new opportunities for more effective HIV prevention programs.
跨性别女性（TW）和男男性行为者（MSM）在 HIV 研究和预防项目中经常被混淆，尽管他们在文化和行为上存在明显差异。
我们研究了秘鲁利马一项大型针对 TW 和 MSM 的治疗即预防研究的基线数据，以评估风险行为的差异。基线评估包括 HIV 检测和一份问卷，其中包括社会人口统计学、性行为、社交场所出席情况以及药物和酒精使用情况。使用泊松回归和稳健标准误差计算调整混杂因素后的患病率比（调整后的患病率比[aPR]）和 95%置信区间（CI），比较 MSM 和 TW 中与 HIV 风险相关的协变量的患病率。
2013 年 7 月至 2015 年 9 月期间，共有 310 名 TW 和 2807 名 MSM 参与了该研究，并纳入了本分析。TW 比 MSM 更倾向于采取一些保护性行为健康的措施，包括过去一年进行 HIV 检测（aPR=1.62；95%CI：1.42 至 1.84）和上次性行为时使用避孕套（aPR=1.20；95%CI：1.06 至 1.36）。TW 更有可能在性行为时饮酒（aPR=1.15；95%CI：1.01 至 1.31）或使用毒品（aPR=2.24；95%CI：1.47 至 3.41），存在酒精依赖（aPR=1.38；95%CI：1.15 至 1.66），接受肛交（aPR=1.31；95%CI：1.26 至 1.36），并收受金钱、礼物或性服务作为回报（1.96；95%CI：1.74 至 2.20）。
TW 和 MSM 表现出不同的风险特征，这表明针对每个群体的特定干预措施可能为更有效的 HIV 预防计划提供新的机会。
