Ribeiro Dos Santos Paulie Marcelly, Cardoso Dos Santos Kamilla, Rodrigues de Oliveira Brunna, Silva Magalhães Larissa, Amorim Caetano Karlla Antonieta, da Silva Carvalho Vila Vanessa, Rezende Pacheco Leonora, Dos Santos Carneiro Megmar Aparecida, Ferreira Dias Sònia, Sttaciarini Jeanne-Marie, Araujo Teles Sheila
Nursing Department, Pontifícia Universidade Católica de Goiás, Goiânia, Brazil.
Faculty of Nursing, Universidade Federal de Goiás, Goiânia, Brazil.
AIDS Care. 2023 Jun;35(6):779-783. doi: 10.1080/09540121.2022.2067316. Epub 2022 Apr 20.
Transgender women (TW) are a key population in the dynamics of human immunodeficiency virus (HIV) dissemination, although little is known about their perceptions of HIV risk. In this embedded, nested, mixed-methods study, we assessed factors associated with condomless sexual intercourse among TW and explored their risk perceptions and vulnerabilities regarding HIV exposure. The first phase involved a cross-sectional study, followed by qualitative interviews. Condomless sexual intercourse during their last sexual encounter was reported by 37.3% of participants, and 16.1% previously tested positive for HIV. Age older than 21 years, single status, and being a sex worker were protective factors for condomless intercourse. Otherwise, TW who reported a past sexual partner with a known sexually transmitted infection and those aware of post-exposure prophylaxis had a greater risk of condomless sexual intercourse ( < 0.05) during their most recent encounter. The qualitative interviews revealed that, despite TW being aware of their risk of contracting HIV, their vulnerabilities overlapped their risk perception, making them trivialize or ignore the risk. This study will help to understand the HIV dynamics among TW and contribute to further health research, education, policymaking, and planning associated with specific health strategies to promote the sexual health of TW.
跨性别女性是人类免疫缺陷病毒（HIV）传播动态中的关键人群，尽管人们对她们对HIV风险的认知知之甚少。在这项嵌入式、嵌套式混合方法研究中，我们评估了与跨性别女性无保护性行为相关的因素，并探讨了她们对HIV暴露的风险认知和脆弱性。第一阶段包括一项横断面研究，随后是定性访谈。37.3%的参与者报告在其最近一次性接触中有无保护性行为，16.1%的人之前HIV检测呈阳性。年龄超过21岁、单身状态以及身为性工作者是无保护性行为的保护因素。否则，报告过去的性伴侣患有已知性传播感染的跨性别女性以及了解暴露后预防措施的跨性别女性在最近一次性接触中发生无保护性行为的风险更高（<0.05）。定性访谈显示，尽管跨性别女性意识到自己感染HIV的风险，但她们的脆弱性与风险认知重叠，导致她们轻视或忽视这种风险。这项研究将有助于了解跨性别女性中的HIV动态，并为进一步的健康研究、教育、政策制定以及与促进跨性别女性性健康的特定健康策略相关的规划做出贡献。
