KHANA Center for Population Health Research, Phnom Penh, Cambodia.
ActionAid Cambodia, Phnom Penh, Cambodia.
PLoS One. 2020 Sep 4;15(9):e0238314. doi: 10.1371/journal.pone.0238314. eCollection 2020.
Globally, the prevalence of HIV among transgender women remains much higher than that of the general population, and a large proportion of them are unaware of their HIV status. Transgender women are exposed to gender-based violence and social stigma and discrimination in different settings that may create significant barriers to receiving HIV prevention and care services. This study aimed to identify factors associated with recent HIV testing among transgender women in Cambodia.
We conducted a cross-sectional survey in 2016 among 1375 transgender women recruited from 13 provinces using a peer-based social network recruitment method. We used a structured questionnaire for face-to-face interviews and performed rapid HIV/syphilis testing onsite. We used a multiple logistic regression analysis to identify factors associated with recent HIV testing.
Of the total, 49.2% of the participants reported having an HIV test in the past six months. After controlling for other covariates, the odds of having an HIV test in the past six months was significantly lower among students (AOR 0.36, 95% CI 0.20-0.65), participants who perceived that they were unlikely to be HIV infected (AOR 0.50, 95% CI 0.32-0.78), and participants who reported always using condoms with male non-commercial partners in the past three months (AOR 0.65, 95% CI 0.49-0.85) relative to their respective reference group. The odds of having an HIV test in the past six months was significantly higher among participants who had been reached by community-based HIV services (AOR 5.01, 95% CI 3.29-7.65) and received HIV education (AOR 1.65, 95% CI 1.06-2.58) in the past six months relative to their respective reference group.
Despite the widely available free HIV testing services, more than half of transgender women in this study had not received an HIV test in the past six months. Our findings suggest that a tailored and comprehensive combination prevention program, in which HIV testing is linked to care continuum and beyond, maybe an essential next step. Social media may have the potential to be promoted and utilized among transgender women populations in order to improve HIV testing and other prevention measures.
在全球范围内，跨性别女性的 HIV 感染率仍然远高于一般人群，其中很大一部分人并不知道自己的 HIV 状况。跨性别女性在不同环境中遭受基于性别的暴力和社会污名化及歧视，这可能会给她们获得 HIV 预防和护理服务带来重大障碍。本研究旨在确定柬埔寨跨性别女性最近进行 HIV 检测的相关因素。
我们于 2016 年采用基于同伴的社会网络招募方法，从柬埔寨 13 个省招募了 1375 名跨性别女性进行横断面调查。我们使用结构化问卷进行面对面访谈，并在现场进行快速 HIV/梅毒检测。我们采用多因素逻辑回归分析确定与最近进行 HIV 检测相关的因素。
在总共的参与者中，49.2%的人报告在过去六个月内进行过 HIV 检测。在控制了其他混杂因素后，过去六个月内进行 HIV 检测的可能性在学生（AOR 0.36，95%CI 0.20-0.65）、认为自己不太可能感染 HIV（AOR 0.50，95%CI 0.32-0.78）和过去三个月内与男性非商业性伴侣每次都使用安全套的参与者（AOR 0.65，95%CI 0.49-0.85）中显著降低，与各自的参照组相比。过去六个月内接受过社区 HIV 服务（AOR 5.01，95%CI 3.29-7.65）和 HIV 教育（AOR 1.65，95%CI 1.06-2.58）的参与者与各自的参照组相比，过去六个月内进行 HIV 检测的可能性显著更高。
尽管有广泛的免费 HIV 检测服务，但本研究中仍有超过一半的跨性别女性在过去六个月内未进行 HIV 检测。我们的研究结果表明，一种量身定制的综合预防方案，将 HIV 检测与关怀延续服务相结合，可能是下一步的关键措施。社交媒体可能具有潜力，可在跨性别女性群体中进行推广和利用，以提高 HIV 检测率和其他预防措施。
