Travestis, an unexplored population at risk of HIV in a large metropolis of northeast Brazil: A respondent-driven sampling survey

Abstract

Travestis are highly vulnerable to HIV infection in Brazil. We conducted a survey among 304 travestis using Respondent-Driven Sampling from August to December 2008. Travestis are young (49% <24 years), poorly educated (55% just elementary school), low social class (62% Class C-E), reside with families (49%) or friends/madam (22%), are victims of homophobia (91%) and violence (61%). They report early sexual debut (75% <14), many sexual partners, drug use during sex (43%), and unprotected sex (male partner, 47%, both male and female partners, 50%). Sex work is common (82%, 59% >10 partners last six months) and relatively low cost (median=US$24). A majority report testing for HIV (69%), and report high prevalence (12% disclosed a positive result). Almost all the respondents refused to test in the study. Interventions, targeted to both travestis and to the general community about sexual discrimination, are necessary.

Acceptability of self-conducted home-based HIV testing among men who have sex with men in Brazil: data from an on-line survey

“…For example, our survey did not include questions to identify or engage transvestite or transgender women, who bear a disproportionate burden of disease in Brazil and worldwide 37,38 . The extent of HIV risk will certainly differ by preferences, gender identities, and sexual networks; this heterogeneity in the “MSM” population makes it necessary to extend research about where to target testing and new testing approaches to the multiplicity of groups who investigators and policy makers refer to as MSM.…”

Syphilis infection, sexual practices and bisexual behaviour among men who have sex with men and transgender women: a cross-sectional study

“…However, due to the difficulty of finding a job, poor education, discrimination and isolation, TW are extremely vulnerable to engaging in commercial sex work 23 24. Furthermore, their gender identity status overlaps with other vulnerabilities, such as poverty, high HIV/STIs prevalence, high levels of alcohol and drug abuse, depression and they are constant victims of violence and harassment 5 7 8. Indeed, both studied groups are stigmatised, but TW are more promptly identified due to their distinctive behaviour and physical appearance 23 24.…”

“…Men who have sex with men (MSM) and transgender women (TW) are highly vulnerable to STIs because of high levels of unprotected sexual practices and multiple sexual partners 5 6. Social stigmatisation and homophobia contribute to low self-esteem, isolation and depression.…”

Risk factors associated with resistance to HIV testing among transwomen in Brazil

“…Often, transwomen are involved in commercial sex, unprotected sex, and use alcohol and other drugs during sexual intercourse (Guadamuz et al, 2011;Martins et al, 2013;Passos & Figueiredo, 2004;Wang et al, 2007).…”