Chen Hui, Chen Yingjie, Liu Shangbin, Yu Xiaoyue, Wang Huwen, Chang Ruijie, Wang Rongxi, Liu Yujie, Xu Chen, Wang Ying, Cai Yong
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China.
Transgend Health. 2024 Jun 17;9(3):222-231. doi: 10.1089/trgh.2022.0081. eCollection 2024 Jun.
Although transgender women (TGW) bear the highest HIV burden worldwide, routine surveillance of this group is rare. We aimed to evaluate the trends in health characteristics of Chinese TGW.
Three cross-sectional studies using snowball sampling were conducted in 2014, 2017, and 2019, primarily in Shenyang, China. A questionnaire and voluntary HIV testing were used to obtain information on background characteristics, sexual behaviors, pre-exposure prophylaxis (PrEP) willingness, and HIV status.
There were 220 respondents in 2014, 198 in 2017, and 247 in 2019 (average age 31.1±7.6 to 33.5±9.6 years). HIV prevalence significantly decreased from 29.5% (95% confidence interval [CI]: 25.3-38.4%) in 2014 to 19.4% (95% CI: 14.7-24.9%) in 2019 (<0.05). The proportion of participants reporting condomless anal intercourse (CAI) with any partner fluctuated from 30.8% (95% CI: 25.1-36.1%) to 53.0% (95% CI: 45.8-60.1%). The proportion of participants willing to use PrEP decreased from 86.4% (95% CI: 81.1-90.6%) in 2014 to 62.8% (95% CI: 56.4-68.8%) in 2019. Factors significantly associated with HIV infection were CAI with any partner (multivariate odds ratio [ORm]: 3.58, 95% CI: 1.55-8.29 in 2017; ORm: 3.18, 95% CI: 1.56-6.46 in 2019) and PrEP willingness (ORm: 0.26, 95% CI: 0.12-0.58 in 2017).
HIV prevalence and associated risk factors remain substantial among Chinese TGW. There is an urgent need to strengthen HIV surveillance in this population, and develop trans-friendly and effective interventions to minimize HIV prevalence and transmission.
尽管跨性别女性（TGW）在全球范围内承受着最高的艾滋病毒负担，但对该群体的常规监测却很少见。我们旨在评估中国跨性别女性的健康特征趋势。
2014年、2017年和2019年在中国沈阳主要采用雪球抽样法进行了三项横断面研究。通过问卷调查和自愿艾滋病毒检测获取有关背景特征、性行为、暴露前预防（PrEP）意愿和艾滋病毒感染状况的信息。
2014年有220名受访者，2017年有198名，2019年有247名（平均年龄从31.1±7.6岁至33.5±9.6岁）。艾滋病毒感染率从2014年的29.5%（95%置信区间[CI]：25.3 - 38.4%）显著下降至2019年的19.4%（95% CI：14.7 - 24.9%）（<0.05）。报告与任何性伴侣进行无保护肛交（CAI）的参与者比例在30.8%（95% CI：25.1 - 36.1%）至53.0%（95% CI：45.8 - 60.1%）之间波动。愿意使用暴露前预防（PrEP）的参与者比例从2014年的86.4%（95% CI：81.1 - 90.6%）降至2019年的62.8%（95% CI：56.4 - 68.8%）。与艾滋病毒感染显著相关的因素包括与任何性伴侣进行无保护肛交（2017年多变量优势比[ORm]：3.58，95% CI：1.55 - 8.29；2019年ORm：3.18，95% CI：1.56 - 6.46）以及暴露前预防意愿（2017年ORm：0.26，9�% CI：0.12 - 0.58）。
中国跨性别女性中的艾滋病毒感染率及相关危险因素仍然很高。迫切需要加强对该人群的艾滋病毒监测，并制定对跨性别者友好且有效的干预措施，以尽量降低艾滋病毒感染率和传播率。
