Rivest Paul
Institut d’ethnologie méditerranéenne, européenne et comparative (Idemec) – Aix-Marseille Université – Aix-en-Provence – France
Sante Publique. 2023;34(HS2):37-48. doi: 10.3917/spub.hs2.0037.
Sexual minorities have been disproportionally impacted by the HIV-Aids epidemic. Their high prevalence motivated sexual health research that first focused on gay men, then trans women. Trans men have been considered at very low risk of exposition, Hence the scarce number of research about them. However, an emerging literature is showing diversified and surprising results regarding the reasons for their initial exclusion.
This article seeks to establish the state of knowledge on trans men's sexual health through a French and international literature review.
Trans men have a variety of partners, sexual and non-sexual practices (IDU) that leads to categorize them at high risk of HIV exposure. The proportion of trans men who are HIV positive still is difficult to assess. It is estimated to be high in the USA, and close to zero in France. Low screening rates, difficulties accessing health care, and identification problems in the very classification of people suggest that they might be more of them. Trans men also report discriminations in access to health care services, and specific health vulnerabilities. Gynecology and reproductive health are rarely even mentioned.
Rethinking the categories used in research would produce a more accurate representation of the varied realities of trans people.
性少数群体受艾滋病毒/艾滋病疫情的影响尤为严重。其高感染率推动了性健康研究，该研究最初聚焦于男同性恋者，随后是跨性别女性。跨性别男性一直被认为感染风险极低，因此关于他们的研究数量稀少。然而，新兴文献就其最初被排除在外的原因呈现出多样化且令人惊讶的结果。
本文旨在通过法语及国际文献综述确定跨性别男性性健康方面的知识现状。
跨性别男性有各种各样的性伴侣以及性和非性方面的行为（注射吸毒），这使他们被归类为高感染艾滋病毒风险人群。跨性别男性中艾滋病毒呈阳性的比例仍难以评估。据估计，在美国这一比例较高，而在法国则接近零。筛查率低、获取医疗保健困难以及在人群分类中的识别问题表明，实际感染人数可能更多。跨性别男性还报告在获取医疗保健服务时受到歧视，以及存在特定的健康脆弱性。妇科和生殖健康甚至很少被提及。
重新思考研究中使用的类别将更准确地呈现跨性别者的多样现实情况。
