Sexual behaviors and vulnerability to sexually transmitted infections among transgender women in Iran

Nematollahi, Azar; Gharibzadeh, Safoora; Damghanian, Maryam; Gholamzadeh, Saeid; Farnam, Farnaz

doi:10.1186/s12905-022-01753-7

Cited by 10 publications

(9 citation statements)

References 34 publications

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“…It is a truth that the existence of STIs in Iran and other Islamic countries is considered taboo by the government and the general public and has created a state of denial that some refer to as a "health crisis behind the veil" (18)(19)(20). In addition, the occurrence of premarital sex has increased over the years (21).…”

Section: Preventive Behaviors Of Stismentioning

confidence: 99%

Preventive Behaviors of Iranian Women Toward Sexually Transmitted Infections: A Perspective of Motivation Protection Theory

Kazemi,

Zarei,

Heidarnia

et al. 2023

J Educ Community Health

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Background: Sexually transmitted infections (STIs) are frequently unreported, representing implied public health concerns, especially for women and in more vulnerable communities. This study aimed to determine the STI preventive behavior of Iranian women and related factors in protection motivation theory (PMT). Methods: A cross-sectional online survey was conducted on a convenience sample from 20 January to 21 March 2021 in Iran. Women who were 18-35 years old with marital status were eligible to participate (N=600). The collected variables included demographic characteristics and STI-related behaviors regarding constructs of PMT: knowledge, perceived vulnerability, perceived self-efficacy, and preventive intention. A Persian version of the Korean four-scale about STI preventive behaviors was used as the assessment tool, and one-way ANOVA and Pearson correlation tests were used for analysis. Results: A significant difference was observed between knowledge, perceived vulnerability, perceived self-efficacy, and preventive intention with sociodemographic variables. STI-perceived vulnerability and STI-knowledge with mean scores of 62.37 and 42.52 were the highest and lowest perceived constructs of preventive behavior, respectively. STI knowledge of Iranian women was low, and STI-preventive self-efficacy was perceived as a positive predictor for STI protective behaviors. Conclusion: A theory-based educational intervention is highly recommended to improve STI-protective behaviors.

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Section: Preventive Behaviors Of Stismentioning

confidence: 99%

Preventive Behaviors of Iranian Women Toward Sexually Transmitted Infections: A Perspective of Motivation Protection Theory

Kazemi,

Zarei,

Heidarnia

et al. 2023

J Educ Community Health

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“…Migrant workers [50] Transgender [39,[54][55][56][57] FSW */inmates [42,47,52,[58][59][60][61][62][63] Homeless community [36] Women [64] Multiple sex partners Transgender [39,44,57] FSW * [42,59,65] Married community [66] Women [67,68] Social Fear of rejection, discrimination, and stigmatization FSW * [58] Migrant workers [50] Lacking awareness and knowledge Transgender [22,39] FSW * [52,60,69] Adolescents [24] Married community [24,37] Homeless community [36] Women (married/pregnant) [25,[27][28][29]67] Personal Personality behaviour: impulsivity FSW */inmates [6,51] Occupation-related risk FSW * [48,52,70,…”

Section: Sexualmentioning

confidence: 99%

Understanding Women’s Knowledge, Awareness, and Perceptions of STIs/STDs in Asia: A Scoping Review

Kaur,

Balakrishnan,

Zhi Wei

et al. 2023

Healthcare

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Objective: This study aimed to conduct a scoping review to collect current literature on the knowledge, awareness, and perception (KAP) of sexually transmitted infections/diseases (STIs/STDs) among women in Asia. Methodology: The PRISMA-Scoping methodology was used in this study to extract papers from four databases published between 2018 and 2022. Sixty-eight articles were included after screening and elimination. Results: The studies on KAP of STIs/STDs among women were largely undertaken in Southeast Asia (Indonesia, Malaysia, and Vietnam) and South Asia (India, Pakistan, and Bangladesh). Regardless of the specific cohort of women studied, research indicates consistently low levels of knowledge and awareness across Asia. This trend seems to be more prevalent among female commercial sex workers, women with lower educational levels, and those in poorer socioeconomic positions. In South Asia, cultural, sociological, economic, and gender inequalities, particularly male domination, all have a significant impact on KAP levels. Conclusion: As education is a major factor that influences health behaviour, this review underscores the need to allocate more resources to educational initiatives, particularly targeting vulnerable groups such as sex workers, transgender women, pregnant women, and rural housewives. This strategic focus may contribute significantly to preventing STIs/STDs, particularly in less developed regions/countries.

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“…The high prevalence of HIV infection among transwomen is associated with GBV[ 12 ], which limits access to HIV prevention, care, and treatment services. Due to the low self-esteem and disempowerment transwomen are also more likely to use psychoactive substances and inconsistently use condoms [ 10 , 13 ], which increases their vulnerability to HIV infection [ 10 , 12 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding the effect of gender-based violence on uptake and utilisation of HIV prevention, treatment, and care services among transgender women: a qualitative study in the greater Kampala metropolitan area, Uganda

Muyanga,

Isunju,

Ssekamatte

et al. 2023

BMC Women's Health

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Background Transwomen (also known as transgender women) are disproportionately affected by all forms of gender-based violence (GBV). The high prevalence of physical, sexual and emotional violence not only predisposes transwomen to HIV infection but also limits the uptake/access to HIV prevention, care, and treatment services. Despite the high prevalence of HIV infection and GBV among transwomen, there is limited evidence on how GBV affects the uptake and utilisation of HIV prevention, care, and treatment services. Therefore, this qualitative study explored how GBV affects uptake and utilisation of HIV prevention, treatment, and care services among transwomen in the Greater Kampala Metropolitan Area (GKMA), Uganda. Methods This participatory qualitative study was conducted among transwomen in the GKMA. A total of 20 in-depth interviews, 6 focus group discussions, and 10 key informant interviews were conducted to explore how GBV affects the uptake and utilisation of HIV prevention, treatment, and care services among transwomen. Data were analysed using a thematic content analysis framework. Data were transcribed verbatim, and NVivo version 12 was used for coding. Results At the individual level, emotional violence suffered by transwomen led to fear of disclosing their HIV status and other health conditions to intimate partners and healthcare providers respectively; inability to negotiate condom use; and non-adherence to antiretroviral therapy (ART). Sexual violence compromised the ability of transwomen to negotiate condom use with intimate partners, clients, and employers. Physical and emotional violence at the community level led to fear among transwomen traveling to healthcare facilities. Emotional violence suffered by transwomen in healthcare settings led to the limited use of pre-exposure prophylaxis and HIV testing services, denial of healthcare services, and delays in receiving appropriate care. The fear of emotional violence also made it difficult for transwomen to approach healthcare providers. Fear of physical violence such as being beaten while in healthcare settings made transwomen shun healthcare facilities. Conclusion The effects of GBV on the uptake and utilisation of HIV prevention, care, and treatment services were observed in individual, community, and healthcare settings. Across all levels, physical, emotional, and sexual violence suffered by transwomen led to the shunning of healthcare facilities, denial of healthcare services, delays in receiving appropriate care, and the low utilisation of post-exposure prophylaxis, and HIV testing services. Given its effects on HIV transmission, there is a need to develop and implement strategies/ interventions targeting a reduction in GBV. Interventions should include strategies to sensitize communities to accept transwomen. Healthcare settings should provide an enabling environment for transwomen to approach any healthcare provider of their choice without fear of experiencing GBV.

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Sexual behaviors and vulnerability to sexually transmitted infections among transgender women in Iran

Cited by 10 publications

References 34 publications

Preventive Behaviors of Iranian Women Toward Sexually Transmitted Infections: A Perspective of Motivation Protection Theory

Preventive Behaviors of Iranian Women Toward Sexually Transmitted Infections: A Perspective of Motivation Protection Theory

Understanding Women’s Knowledge, Awareness, and Perceptions of STIs/STDs in Asia: A Scoping Review

Understanding the effect of gender-based violence on uptake and utilisation of HIV prevention, treatment, and care services among transgender women: a qualitative study in the greater Kampala metropolitan area, Uganda

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