Department of Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany.
ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
BMC Public Health. 2024 Oct 31;24(1):3013. doi: 10.1186/s12889-024-20464-2.
BACKGROUND: Trans and non-binary people are often discriminated against. Discrimination has a negative impact on health and may affect sexual health and behavior. We explored the relationship between discrimination based on gender identity and the perceived ability to make decisions about their sex life to feel as protected as desired from HIV and sexually transmitted infections (STI) among trans and non-binary people in Germany. Secondarily, we assessed whether feeling unable of making HIV/STI-protected sex decisions was associated with behaviors related to increased HIV/STI risk. METHODS: We conducted a cross-sectional study using data from the Sexual Health and HIV/STI in Trans and Non-Binary Communities (TASG) survey conducted online between March-July 2022 among trans and/or non-binary people aged 18 years and older living in Germany. We described the prevalence of frequent discrimination based on gender identity. We calculated prevalence ratios (PR) with 95% confidence intervals (95% CI) for the associations between frequent experienced discrimination based on gender identity and feeling unable of making HIV/STI-protected sex decisions, and between feeling unable of making HIV/STI-protected sex decisions and behaviors related to increased HIV/STI risk. RESULTS: Among 3077 participants, 22% reported frequent discrimination based on gender identity. Participants experiencing such discrimination reported 1.4 times more often to feel unable to make HIV/STI-protected sex decisions (PR 1.4, 95% CI 1.1-1.8). This perceived inability was associated with increased prevalence of sex under drug influence (PR 2.9, 95% CI 2.3-3.7) and condomless penetrative sex with multiple partners without PrEP (PR 2.0, 95% CI 1.4-2.9). CONCLUSION: Feeling unable to make decisions to feel protected from HIV/STI among trans and non-binary people was associated with both frequent discrimination and behaviors that increase the HIV/STI risk. Strategies for empowering trans and non-binary people to assert their sexual decision-making needs should be explored.
背景：跨性别者和非二元性别者经常受到歧视。歧视对健康有负面影响，可能会影响性健康和行为。我们探讨了基于性别认同的歧视与跨性别者和非二元性别者对性生 活做出保护自己免受 HIV 和性传播感染（STI）的决策能力之间的关系，这在德国。其次，我们评估了无法做出 HIV/STI 保护性行为决策是否与增加 HIV/STI 风险的行为有关。
方法：我们使用 2022 年 3 月至 7 月期间在德国在线进行的跨性别和非二元群体性健康和 HIV/STI（TASG）调查的数据，开展了一项横断面研究。我们描述了基于性别认同的频繁歧视的流行率。我们计算了基于性别认同的频繁经历歧视与无法做出 HIV/STI 保护性行为决策之间的关联的患病率比（PR）及其 95%置信区间（95%CI），以及无法做出 HIV/STI 保护性行为决策与增加 HIV/STI 风险的行为之间的关联。
结果：在 3077 名参与者中，22%报告了基于性别认同的频繁歧视。经历这种歧视的参与者更经常报告无法做出 HIV/STI 保护性行为决策（PR 1.4，95%CI 1.1-1.8）。这种感知到的无能与性受药物影响的发生率增加有关（PR 2.9，95%CI 2.3-3.7）和没有 PrEP 的情况下与多个伴侣无保护的肛交（PR 2.0，95%CI 1.4-2.9）。
结论：跨性别者和非二元性别者无法做出保护自己免受 HIV/STI 的决策与频繁歧视和增加 HIV/STI 风险的行为有关。应探索增强跨性别者和非二元性别者的性决策需求的策略。
J Health Monit. 2020-3-18
Int J Transgend. 2019-1-21
Pediatrics. 2020-3-17
Front Psychol. 2019-6-25
Zotero 插件