Arora Tanvi, Wadhwa Neelam, Pandhi Deepika, Diwaker Preeti, Arora Vinod K
Department of Pathology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
J Family Med Prim Care. 2021 Dec;10(12):4463-4470. doi: 10.4103/jfmpc.jfmpc_634_21. Epub 2021 Dec 27.
In India, sexuality not confirming to hetero-conjugal and peno-vaginal norm is abhorred and discriminated against. Individuals engaging in Receptive Anal Intercourse (RAI) are marginalized. Reappraisal of their sexual health conditions is likely to promote inclusive health care.
Eighty-five consenting adults with RAI history were recruited from a tertiary care hospital in Delhi. Clinico-demographic data was noted and anal cytology samples were reported by Bethesda 2014 terminology.
There were 29 transgenders (TGs), 51 males (31 bisexual) and five females. Fifty-four subjects were Human Immunodeficiency Virus (HIV) infected (22 TGs, 31 males (17 bisexual) and one female) and 52 were receiving anti-retroviral treatment (ART). Thirty-one subjects had anal warts (6 TGs, 20 males, five females). Anal cytology revealed squamous intra-epithelial lesions (SIL) in 20 (5 TGs, 13 males, two females). TGs had significantly risker sexual practices than homosexual males, bisexual males and females, with consistently earlier age of first RAI exposure and frequent childhood (≤16 years) RAI experience compared to homosexual males, bisexual males and females, even after stratification by HIV status, warts and SIL.
TGs had the highest sexual health risk profile including higher frequency of HIV infection compared to other subjects with RAI history. Bisexuality was common; their risk profile was variably lower than homosexual males. Mindfulness of above is likely to help overcome barriers to health care access and promote compassionate approach at all levels including primary care physicians.
在印度，不符合异性婚姻和阴茎-阴道性行为规范的性取向受到憎恶和歧视。进行接受性肛交（RAI）的个体被边缘化。重新评估他们的性健康状况可能会促进包容性医疗保健。
从德里的一家三级护理医院招募了85名有RAI史的同意参与的成年人。记录临床人口统计学数据，并根据2014年贝塞斯达术语报告肛门细胞学样本。
有29名 transgender（TGs）、51名男性（31名双性恋者）和5名女性。54名受试者感染了人类免疫缺陷病毒（HIV）（22名TGs、31名男性（17名双性恋者）和1名女性），52名正在接受抗逆转录病毒治疗（ART）。31名受试者有肛门疣（6名TGs、20名男性、5名女性）。肛门细胞学检查发现20例（5名TGs、13名男性、2名女性）有鳞状上皮内病变（SIL）。与同性恋男性、双性恋男性和女性相比，TGs的性行为风险显著更高，与同性恋男性、双性恋男性和女性相比，即使按HIV状态、疣和SIL分层后，首次进行RAI的年龄始终更早，且儿童期（≤16岁）进行RAI的经历更频繁。
与其他有RAI史的受试者相比，TGs的性健康风险最高，包括HIV感染频率更高。双性恋很常见；他们的风险状况比同性恋男性的风险状况不同程度地更低。了解上述情况可能有助于克服获得医疗保健的障碍，并在包括初级保健医生在内的各级推广富有同情心的方法。
