World Health Organization Collaborating Centre for HIV Strategic Information, University of Zagreb School of Medicine, Zagreb, Croatia; and Corresponding author. Email:
World Health Organization Collaborating Centre for HIV Strategic Information, University of Zagreb School of Medicine, Zagreb, Croatia.
Sex Health. 2021 Sep;18(4):311-318. doi: 10.1071/SH21061.
Background Biobehavioural data on transgender women (TGW) are limited globally.
We used data collected as part of the 2017-18 National Integrated HIV Biobehavioural Survey, which included 254 TGW in Colombo and 252 in Jaffna, for structured questionnaire interviews and biological testing. We performed multivariable logistic regression analysis to explore factors associated with condom use.
We found low HIV prevalence in Colombo (0.6%) and no HIV infections in Jaffna. TGW in Colombo had higher positivity on the Treponema pallidum-particle agglutination test (2.5%) compared with TGW in Jaffna (0.4%). We found no hepatitis B infections. In both cities, <25% of TGW have comprehensive knowledge about HIV prevention. In Colombo 54.4%, but only 21.4% of TGW in Jaffna, have ever been tested for HIV. Drug-injecting behaviours are uncommon in both cities (prevalence <1%), whereas 7.4% reported sharing equipment for injecting feminising hormones in Colombo. Greater proportions of TGW in Colombo compared with Jaffna used condom at last sex (82.3% vs 37.7%). Multivariable analysis showed lower odds of condom use at last sex in TGW aged >30 years and those who did not test for HIV in the past 12 months in Colombo, and for TGW with higher income in Jaffna, TGW not visiting outdoor sites to find partners, and TGW who sold sex.
Current burden of HIV, syphilis and hepatitis B among TGW in Sri Lanka is low. Although risk behavioural patterns vary between the cities, a substantial sexually transmitted infection vulnerability is a common denominator, calling for strengthening of the capacity to respond to specific TGW needs.
全球范围内，跨性别女性（TGW）的生物行为学数据有限。
我们使用了 2017-18 年国家综合艾滋病毒生物行为学调查收集的数据，该调查包括科伦坡的 254 名 TGW 和贾夫纳的 252 名 TGW，进行了结构化问卷访谈和生物检测。我们进行了多变量逻辑回归分析，以探讨与 condom 使用相关的因素。
我们发现科伦坡的 HIV 感染率较低（0.6%），贾夫纳没有 HIV 感染。科伦坡的 TGW 梅毒螺旋体颗粒凝集试验阳性率（2.5%）高于贾夫纳（0.4%）。我们没有发现乙型肝炎感染。在这两个城市，<25%的 TGW 对 HIV 预防有全面的认识。在科伦坡，54.4%的 TGW 进行过 HIV 检测，但贾夫纳只有 21.4%。在这两个城市，药物注射行为都不常见（发生率<1%），但 7.4%的 TGW 报告在科伦坡曾共用注射雌性激素的设备。与贾夫纳相比，科伦坡更多的 TGW 在最近一次性行为中使用 condom（82.3%对 37.7%）。多变量分析显示，在科伦坡，年龄>30 岁的 TGW、过去 12 个月未进行 HIV 检测的 TGW、收入较高的 TGW、不去户外场所寻找伴侣的 TGW、以及从事性交易的 TGW，最近一次性行为中使用 condom 的可能性较低。
目前，斯里兰卡 TGW 的 HIV、梅毒和乙型肝炎负担较低。尽管两个城市的风险行为模式不同，但普遍存在性传播感染的脆弱性，这需要加强能力，以满足 TGW 的具体需求。
