Section of AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Nanjing Medical University, Nanjing, China.
J Int AIDS Soc. 2019 Nov;22(11):e25417. doi: 10.1002/jia2.25417.
Transgender women may face the highest prevalence of HIV of any population, experiencing a disproportionate burden of disease frequently confirmed in surveys throughout the developing and developed world. However, few studies have been conducted specifically for transgender women in China. This study aimed to measure HIV prevalence and explore risk factors for infection in a diverse sample of Chinese transgender women to help advocate for prevention and care interventions for this population.
From July 2018 to May 2019, we adapted a respondent-driven sampling (RDS) approach to recruit a diverse sample of 250 transgender women through chains of peer referrals in two cities of eastern China, Nanjing and Suzhou. Eligible participants (i.e. 18 years of age or older, living in Jiangsu province and assigned male sex at birth but currently self-identified as a gender different from male) completed a self-administered questionnaire on a mobile phone to collect demographic characteristics and risk behaviours and underwent HIV testing.
The survey sample was young (82% under age 35 years), with 28.8% having a university degree, 39.2% reporting work at entertainment venues, 47.6% ever having taken hormones and 6.4% being diagnosed with an STI in the last year. One in five (20.8%) reported having engaged in sex work. HIV prevalence was 14.8% (95% CI 10.6 to 19.8), with 75.6% of those testing HIV positive reporting they were already aware of their serostatus. In multivariate analysis, HIV prevalence was significantly higher among transgender women above the age of 24 years, those who work at entertainment venues, who never have taken hormones, and who had been diagnosed with an STI in the last year.
The prevalence of HIV among transgender women in our study, at 14.8%, is among the highest detected in any population in eastern China. Chinese transgender women may therefore follow the disparity in the burden of HIV noted worldwide. Data support policies to prioritize transgender women for HIV testing outreach, for in-depth research to better understand the specific drivers of infection in this population, and for trans-friendly HIV care and prevention programmes to address their specific needs.
跨性别女性可能是所有人群中 HIV 感染率最高的人群，在发展中国家和发达国家的调查中，她们经常面临不成比例的疾病负担。然而，在中国，针对跨性别女性的研究很少。本研究旨在通过在东部的两个城市南京和苏州，通过同伴推荐的方式招募一个多样化的中国跨性别女性样本，以测量 HIV 的流行率并探讨感染的风险因素，从而帮助倡导针对该人群的预防和护理干预措施。
2018 年 7 月至 2019 年 5 月，我们采用了回应者驱动抽样（RDS）方法，通过同伴推荐的方式在江苏省的两个城市南京和苏州招募了 250 名多样化的跨性别女性。符合条件的参与者（即年龄在 18 岁或以上，出生时被指定为男性但目前自我认同为不同于男性的性别）通过手机完成了一份自我管理的问卷，以收集人口统计学特征和风险行为，并接受了 HIV 检测。
调查样本较年轻（82%年龄在 35 岁以下），其中 28.8%拥有大学学历，39.2%报告在娱乐场所工作，47.6%曾服用过激素，6.4%在过去一年中被诊断出患有性传播感染。五分之一（20.8%）的人报告曾从事性工作。HIV 感染率为 14.8%（95%置信区间为 10.6%至 19.8%），其中 75.6%接受检测呈 HIV 阳性的人表示他们已经知道自己的血清状况。在多变量分析中，24 岁以上、在娱乐场所工作、从未服用过激素以及在过去一年中被诊断患有性传播感染的跨性别女性 HIV 感染率显著更高。
在我们的研究中，跨性别女性的 HIV 感染率为 14.8%，是中国东部地区任何人群中检测到的最高水平之一。因此，中国的跨性别女性可能遵循了全球范围内 HIV 负担不均的现象。数据支持优先为跨性别女性进行 HIV 检测外展的政策，以便对该人群中的感染特定驱动因素进行深入研究，并制定友好于跨性别者的 HIV 护理和预防计划，以满足他们的特定需求。
