Prevalence of human immunodeficiency virus infection among transgender men in Rawalpindi (Pakistan)

Abstract

BackgroundTransgender males are at high risk for sexually transmitted diseases including AIDS caused by the notorious Human Immunodeficiency Virus (HIV), yet little consideration is given by the policy makers, researchers and non-governmental organizations (NGOs) towards this sensitive issue in Pakistan.MethodsIn this study, we have investigated the prevalence of HIV infection among 306 transgender males with a median age of 29 years (range 15–64 years) residing in Rawalpindi, Pakistan. Rapid HIV antibody-screening methods including the strip test and Enzyme Linked Immuno-absorbent tests were employed to detect HIV antibodies among the subjects. For further confirmation, Polymerase Chain Reaction (PCR) was carried out. Statistical analytical techniques utilized included logistic regression and chi-square.ResultsHIV-1 was found to be the predominant viral subtype. PCR confirmed 21.6% (Confidence Interval 0.17-0.26) of the respondents were reported being HIV positive. 15.7% of the transgender men who shave at home and 13.7% of the transgender men who were educated below 5th grade were found to have HIV.ConclusionThis study shows a very high prevalence of HIV among transgender males. Unawareness among these individuals about the ramifications of this infection owes largely to lack of education. The spread rate is alarming and HIV epidemic is imminent if awareness is not widespread.

Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People

“…81 Among hijra sex workers in Pakistan, laboratory-confirmed prevalence was 6.4%–7.2% in 2 studies, 71 , 75 and 21.6% in a third. 69 Laboratory-confirmed and self-reported HIV prevalence, and sampling approaches were highly variable in other countries, primarily in southern Europe.…”

HIV epidemics among transgender women

“…Despite growing awareness of transgender identities, many current studies refer to transgender women as “transgender males,” “transgender men,” “males by nature but appearing as women.” etc. [38] When collecting data with transgender populations, using language that is consistent with their gender identity may improve participation. Andraski et al [39] recommend addressing barriers to research participation by transgender women through: (a) cultural competency training, (b) transgender-friendly environments, (c) true partnerships with local transgender-friendly organizations and health care providers, (d) protocols that focus on transgender-specific issues, and (e) data collection and tracking of transgender individuals.…”

“…In many parts of the world, transgender people have formed their own community and family structures. For example, Akhtar and colleagues [38] found that only four individuals in a sample of 306 hijras in Pakistan lived with their families of origin. The majority lived together as a clan in all-hijra communities with a guru (group leader).…”

A literature analysis of scientific research on gender incongruence in Muslim nations

“… 25 – 27 Furthermore, the subject population was more clearly defined in the Turkish and Iranian. 28 – 30 While most studies from southeastern countries had collected data from a generalized transgender population, which may have included a mix of intersex people, cross-dressers, or transgender people with or without gender dysphoria 25 – 27 …”