Pletta David R, Mayer Kenneth H, Chen Jarvis T, Hughto Jaclyn M W, Keuroghlian Alex S, Radix Asa E, Reisner Sari L
Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Transgend Health. 2024 Dec 16;9(6):508-515. doi: 10.1089/trgh.2023.0159. eCollection 2024 Dec.
Transgender and nonbinary adults (TNB) are disproportionately burdened by sexually transmitted infections (STI) and the human immunodeficiency virus (HIV). This study investigated whether gender-affirming hormone therapy was associated with TNB adults' odds of screening for STI and HIV.
Longitudinal data came from the electronic medical records of TNB primary care patients receiving care at two community health centers located in Boston, Massachusetts, and New York City, New York, between January 2013 and December 2019. Missing data were addressed using multiple imputation with chained equations, and statistical analyses included the use of unadjusted and covariate-adjusted logistic generalized estimating equation models. Models examined whether gender-affirming hormone therapy was significantly associated with patients' concurrent odds of STI and HIV screening between 2016 and 2019 (i.e., patients screening within the same year they had an active hormone prescription).
Gender-affirming hormone therapy was associated with statistically significant higher odds of STI screening (chlamydia and gonorrhea), but not HIV screening, among TNB patients (STI screening: adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI] = [1.05, 1.49]; HIV screening: aOR = 1.21, 95% CI = [1.00, 1.47]). Additionally, taking preexposure prophylaxis (PrEP) for HIV prevention was associated with increased odds of both STI and HIV screening (STI screening: aOR = 3.74, 95% CI = [1.82, 7.71]; HIV screening: aOR = 4.41, 95% CI = [2.25, 8.64]).
Primary care appointments for the provision of gender-affirming hormones may be an opportune time to incorporate routine STI/HIV screening for sexually active TNB patients. The provision of gender-affirming hormone therapy and PrEP may increase patients' odds of routine STI/HIV screening.
跨性别和非二元性别成年人（TNB）承受着不成比例的性传播感染（STI）和人类免疫缺陷病毒（HIV）负担。本研究调查了性别肯定激素疗法是否与TNB成年人进行STI和HIV筛查的几率相关。
纵向数据来自2013年1月至2019年12月期间在马萨诸塞州波士顿和纽约市的两个社区卫生中心接受治疗的TNB初级保健患者的电子病历。使用链式方程多重填补法处理缺失数据，统计分析包括使用未调整和协变量调整的逻辑广义估计方程模型。模型检验了性别肯定激素疗法是否与2016年至2019年期间患者同时进行STI和HIV筛查的几率显著相关（即患者在有活性激素处方的同一年进行筛查）。
在TNB患者中，性别肯定激素疗法与STI筛查（衣原体和淋病）几率在统计学上显著更高相关，但与HIV筛查无关（STI筛查：调整后的优势比[aOR]=1.25，95%置信区间[CI]=[1.05，1.49]；HIV筛查：aOR=1.21，95%CI=[1.00，1.47]）。此外，服用HIV暴露前预防药物（PrEP）与STI和HIV筛查几率增加相关（STI筛查：aOR=3.74，95%CI=[1.82，7.71]；HIV筛查：aOR=4.41，95%CI=[2.25，8.64]）。
提供性别肯定激素的初级保健预约可能是为性活跃的TNB患者纳入常规STI/HIV筛查的合适时机。提供性别肯定激素疗法和PrEP可能会增加患者进行常规STI/HIV筛查的几率。
