马来西亚吉隆坡大都市区跨性别女性性工作者和 cisgender 女性性工作者中新诊断出的 HIV 感染的相关因素。
Correlates of newly diagnosed HIV infection among cisgender women sex workers and transgender women sex workers in Greater Kuala Lumpur, Malaysia.
机构信息
Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, 12228Yale University School of Medicine, New Haven, CT, USA.
Faculty of Medicine, Centre of Excellence for Research in AIDS (CERiA), 37447University of Malaya, Kuala Lumpur, Malaysia.
出版信息
Int J STD AIDS. 2021 Jun;32(7):609-619. doi: 10.1177/0956462420970417. Epub 2021 Mar 22.
Globally, cisgender women sex workers (CWSWs) and transgender women sex workers (TWSWs) experience increased vulnerabilities to HIV infection. Unfortunately, there is limited data on the drivers of HIV infection in these two understudied populations, particularly in Southeast Asia. To better understand factors associated with HIV infection, we evaluated correlates of newly diagnosed HIV infection in these two populations in Greater Kuala Lumpur, Malaysia. A total of 469 women (CWSW: = 283; TWSW: = 186) were included in this study. Most participants who tested HIV+ were unaware of their infection (59.6%; = 34/57). Separate binary and multivariable logistic regressions were conducted to identify correlates of newly diagnosed HIV in CWSWs and TWSWs. Among CWSWs, (aOR = 5.66; = 0.007) and lifetime use of ecstasy/MDMA (aOR = 5.34; = 0.03) were associated with newly diagnosed HIV, while condomless vaginal sex with clients was associated with lower likelihood of HIV infection (aOR = 0.98; = 0.01). Among TWSWs, being single (aOR = 6.76; = 0.03), using mobile application to solicit clients (aOR = 25.33; = 0.006), and having infection (aOR = 88.22, = 0.02) were associated with newly diagnosed HIV. Expansion of HIV/sexually transmitted infection screening is needed to increase detection of HIV and linkage to care for sex workers. Interventions to reduce HIV infection among CWSWs and TWSWs should be tailored to these populations' unique vulnerabilities.
全球范围内,跨性别女性性工作者(TWSW)和 cisgender 女性性工作者(CWSW)面临更高的 HIV 感染风险。不幸的是,针对这两个研究较少的人群,特别是在东南亚地区,HIV 感染的驱动因素数据有限。为了更好地了解与 HIV 感染相关的因素,我们评估了马来西亚吉隆坡大都市区这两个人群中新发 HIV 感染的相关因素。本研究共纳入 469 名女性(CWSW: = 283;TWSW: = 186)。大多数 HIV 检测阳性的参与者并不知道自己感染了 HIV(59.6%; = 34/57)。分别对 CWSW 和 TWSW 中与新发 HIV 相关的因素进行二元和多变量逻辑回归分析。在 CWSW 中,(aOR = 5.66; = 0.007)和使用摇头丸/ MDMA 的终生经历(aOR = 5.34; = 0.03)与新发 HIV 相关,而与客户发生无保护的阴道性行为与 HIV 感染的可能性降低相关(aOR = 0.98; = 0.01)。在 TWSW 中,单身(aOR = 6.76; = 0.03)、使用移动应用程序招揽客户(aOR = 25.33; = 0.006)和患有 感染(aOR = 88.22; = 0.02)与新发 HIV 相关。需要扩大 HIV/性传播感染筛查,以提高对性工作者的 HIV 检测率和治疗率。针对 CWSW 和 TWSW 的 HIV 感染干预措施应针对这些人群的独特脆弱性进行调整。