全球跨性别者中的 HIV 负担：一项更新的系统评价和荟萃分析。
The worldwide burden of HIV in transgender individuals: An updated systematic review and meta-analysis.
机构信息
Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands.
出版信息
PLoS One. 2021 Dec 1;16(12):e0260063. doi: 10.1371/journal.pone.0260063. eCollection 2021.
INTRODUCTION
Transgender individuals are at risk for HIV. HIV risks are dynamic and there have been substantial changes in HIV prevention (e.g., pre-exposure prophylaxis [PrEP]). It is thus time to revisit HIV prevalence and burden among transgender individuals. The objective of this systematic review and meta-analysis was thus to examine worldwide prevalence and burden of HIV over the course of the epidemic among trans feminine and trans masculine individuals.
METHODS
We conducted an updated systematic review by searching PsycINFO, PubMed, Web of Science, and Google Scholar, for studies of any research design published in in a peer-reviewed journal in any language that reported HIV prevalence among transgender individuals published between January 2000 and January 2019. Two independent reviewers extracted the data and assessed methodological quality. We then conducted a meta-analysis, using random-effects modelling, to ascertain standardized prevalence and the relative burden of HIV carried by transgender individuals by country and year of data collection, and then by geographic region. We additionally explored the impact of sampling methods and pre-exposure prophylaxis (PrEP).
RESULTS
Based on 98 studies, overall standardized HIV prevalence over the course of the epidemic, based on weights from each country by year, was 19.9% (95% CI 14.7% - 25.1%) for trans feminine individuals (n = 48,604) and 2.56% (95% CI 0.0% - 5.9%) for trans masculine individuals (n = 6460). Overall OR for HIV infection, compared with individuals over age 15, was 66.0 (95% CI 51.4-84.8) for trans feminine individuals and 6.8 (95% CI 3.6-13.1) for trans masculine individuals. Prevalence varied by geographic region (13.5% - 29.9%) and sampling method (5.4% - 37.8%). Lastly, PrEP effects on prevalence could not be established.
CONCLUSION
Trans feminine and trans masculine individuals are disproportionately burdened by HIV. Their unique prevention and care needs should be comprehensively addressed. Future research should further investigate the impact of sampling methods on HIV prevalence, and monitor the potential impact of PrEP.
简介
跨性别者有感染 HIV 的风险。HIV 风险是动态的，HIV 预防措施（例如暴露前预防 [PrEP]）发生了重大变化。因此，现在是时候重新审视跨性别者的 HIV 流行率和负担了。本系统评价和荟萃分析的目的是检查整个流行过程中跨性别女性和跨性别男性个体的 HIV 全球流行率和负担。
方法
我们通过搜索 PsycINFO、PubMed、Web of Science 和 Google Scholar，对发表在同行评议期刊上的任何研究设计的研究进行了更新的系统评价，这些研究以任何语言报告了 2000 年 1 月至 2019 年 1 月期间跨性别者的 HIV 流行率。两位独立的审查员提取数据并评估方法学质量。然后，我们使用随机效应模型进行荟萃分析，以确定按国家和数据收集年份以及按地理区域确定的 HIV 标准化流行率和跨性别者的 HIV 相对负担。我们还探讨了采样方法和暴露前预防（PrEP）的影响。
结果
基于 98 项研究，根据每年每个国家的权重，在整个流行过程中，跨性别女性个体（n = 48,604）的标准化 HIV 总体流行率为 19.9%（95%CI 14.7% - 25.1%），跨性别男性个体（n = 6460）为 2.56%（95%CI 0.0% - 5.9%）。与 15 岁以上的个体相比，HIV 感染的总体比值比（OR）为 66.0（95%CI 51.4-84.8），跨性别女性个体为 6.8（95%CI 3.6-13.1）。流行率因地理区域（13.5% - 29.9%）和采样方法（5.4% - 37.8%）而异。最后，无法确定 PrEP 对流行率的影响。
结论
跨性别女性和跨性别男性个体 HIV 负担过重。应全面解决他们独特的预防和护理需求。未来的研究应进一步调查采样方法对 HIV 流行率的影响，并监测 PrEP 的潜在影响。
Zotero 插件