Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran.
BMC Womens Health. 2022 May 14;22(1):170. doi: 10.1186/s12905-022-01753-7.
Transgender people are at serious risk for HIV infection and other sexually transmitted infections (STIs), they are four times more likely to experience HIV infection than the general population. The aim of this study was to assess sexual behaviors and vulnerability of transgender women to STIs including HIV.
A cross-sectional study was conducted using convenient sampling from August 2019 to March 2020 in Iran at "Support center for Iranian transgender" and "Shiraz Forensic Medicine" where transgender individuals refer to follow the steps of gender affirmation. 127 transgender women participated in this study. A researcher-made questionnaire was applied for evaluating sexual behaviors, STIs and HIV.
The mean age of participants and their age of sexual debut were 27.6 and 16.9, respectively. 92.1% of participants were single with experience of sex and 59.3% had one sex partner in the last 2 years. 96.9% of the participants were heterosexual with 67.2% reporting experiencing orgasm in at least 50% of their sexual intercourse. However, 42.5% reported sexual pain and the same percentage reported low or very low sexual satisfaction. About half of the participants used condoms occasionally during sex (48.7%) and the most important reason for not using condoms in most cases was not having a condom (37.9%). Some of participants had little knowledge of the symptoms (33.9%) and complications (44.1%) of STIs. Although 87.4% and 72.4% of participants had never been tested for a STI and HIV, 1.6% were HIV positive and 18.1% had a history of STIs. Also, 26% of people had undergone vaginoplasty and a significant association was observed between vaginoplasty with sexual satisfaction (p < 0. 01(.
Some of transgender women in this study were involved in high-risk sexual behaviors while unaware of the signs and symptoms of STIs. Also, despite reaching orgasm in most of their sexual relationships, they had little sexual satisfaction that could probably be related to body dissatisfaction, and lack of vaginoplasty in the majority of them. The need for gender affirming surgeries and psychiatric interventions affecting body satisfaction was identified in this group.
跨性别者感染艾滋病毒和其他性传播感染（STI）的风险很高，他们感染艾滋病毒的可能性是普通人群的四倍。本研究旨在评估跨性别女性的性行为和 STI 易感性，包括艾滋病毒。
2019 年 8 月至 2020 年 3 月，采用方便抽样法在伊朗“伊朗跨性别者支持中心”和“设拉子法医”进行了一项横断面研究，跨性别者在这些地方接受性别确认的步骤。共有 127 名跨性别女性参与了这项研究。研究人员使用自制问卷评估性行为、性传播感染和艾滋病毒。
参与者的平均年龄和性初潮年龄分别为 27.6 岁和 16.9 岁。92.1%的参与者是单身，有性经验，59.3%的人在过去 2 年内有一个性伴侣。96.9%的参与者是异性恋者，其中 67.2%的人报告在至少 50%的性行为中达到性高潮。然而，42.5%的人报告有性疼痛，同样比例的人报告性满意度低或非常低。约一半的参与者在性行为中偶尔使用避孕套（48.7%），大多数情况下不使用避孕套的主要原因是没有避孕套（37.9%）。一些参与者对性传播感染的症状（33.9%）和并发症（44.1%）知之甚少。尽管 87.4%和 72.4%的参与者从未接受过性传播感染和艾滋病毒检测，但 1.6%的人艾滋病毒呈阳性，18.1%的人有性传播感染史。此外，26%的人接受了阴道成形术，阴道成形术与性满意度之间存在显著关联（p<0.01）。
本研究中的一些跨性别女性参与了高风险的性行为，同时对性传播感染的迹象和症状一无所知。此外，尽管她们在大多数性关系中达到了性高潮，但她们的性满意度很低，这可能与身体不满有关，而且她们中的大多数人都没有进行阴道成形术。本研究发现，这一群体需要进行性别肯定手术和影响身体满意度的精神干预。
