Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.
KHANA Center for Population Health Research, Phnom Penh, Cambodia.
BMC Public Health. 2019 Mar 20;19(1):326. doi: 10.1186/s12889-019-6656-x.
Globally, the prevalence of HIV among transgender women is much higher than that of the general adult population. This can be explained by the persistently low rate of consistent condom use among this population. This study was therefore conducted to explore factors associated with consistent condom use among sexually-active transgender women in Cambodia, specifically with their non-commercial partners.
Data used for this study were collected as part of the National Integrated Biological and Behavioral Survey 2016. Participants were recruited from the capital city of Phnom Penh and 12 other provinces with high burden of HIV using the Respondent-Driven Sampling (RDS) method. Face-to-face interviews were conducted using a structured questionnaire. Weighted multivariate logistic regression analysis was conducted to explore independent factors associated with consistent condom use.
This study included 1202 transgender women who reported having anal sex with at least one male partner not in exchange for money or gifts in the past three months. The mean age of the participants was 26.0 (SD = 7.0) years. Of the total, 41.5% reported always using condoms with male non-commercial partners in the past three months. After adjustment, the likelihood of consistent condom use was significantly higher among participants who resided in an urban community (AOR = 1.7, 95% CI = 1.1-2.6), had attained at least 10 years of formal education (AOR = 1.8, 95% CI = 1.2-2.7), perceived that they were likely or very likely to be HIV infected (AOR = 2.9, 95% CI = 2.0-4.1), reported drinking alcohol two to three times per week (AOR = 3.1, 95% CI = 1.1-8.3), reported using amphetamine-type stimulants (AOR = 1.9, 95% = 1.1-3.8) or other drugs (AOR = 7.6, 95% CI = 1.5-39.5), and reported inconsistent condom use with male commercial partners in the past three months (AOR = 4.3, 95% CI = 1.8-10.4) compared to that of their respective reference group.
This study confirms the low rates of condom use, particularly in non-commercial relationship, among transgender women in Cambodia. To address these concerns, efforts towards education about effects of multiple, concurrent relationships, and inconsistent condom use should be reinforced among transgender women.
在全球范围内，跨性别女性中的艾滋病毒感染率远远高于普通成年人群。这可以用该人群中持续低比例的一致性 condom 使用来解释。因此，本研究旨在探讨柬埔寨活跃的跨性别女性与非商业性伴侣保持 condom 使用一致性的相关因素。
本研究使用的数据来自 2016 年全国综合生物和行为调查。参与者是通过受访者驱动抽样 (RDS) 方法从首都金边和其他 12 个艾滋病毒负担高的省份招募的。使用结构化问卷进行面对面访谈。采用加权多变量逻辑回归分析探讨与 condom 使用一致性相关的独立因素。
本研究包括 1202 名跨性别女性，她们报告在过去三个月中与至少一名非商业性男性伴侣发生过肛交。参与者的平均年龄为 26.0（SD=7.0）岁。在所有参与者中，41.5%的人报告在过去三个月中与非商业性男性伴侣始终使用 condom。调整后，居住在城市社区（AOR=1.7，95%CI=1.1-2.6）、完成至少 10 年正规教育（AOR=1.8，95%CI=1.2-2.7）、认为自己可能或非常可能感染艾滋病毒（AOR=2.9，95%CI=2.0-4.1）、报告每周饮酒 2-3 次（AOR=3.1，95%CI=1.1-8.3）、报告使用安非他命类兴奋剂（AOR=1.9，95%CI=1.1-3.8）或其他药物（AOR=7.6，95%CI=1.5-39.5）、以及在过去三个月中与商业性男性伴侣 condom 使用不一致（AOR=4.3，95%CI=1.8-10.4）的参与者， condom 使用一致性的可能性显著高于各自的参照组。
本研究证实了柬埔寨跨性别女性 condom 使用率低，尤其是在非商业性关系中。为了解决这些问题，应加强针对跨性别女性多性伴和 condom 使用不一致的影响的教育。
