High-Risk Sexual Behaviors Among Transgender Individuals in Tehran, Iran
-
Amir Hossein Jalali Nadoushan
,
Alaleh Bahramian
,
Mojgan Taban
,
Kaveh Alavi
,
Hamid Sharifi
,
Mostafa Shokoohi
,
Mehrdad Eftekhar Ardebili
Abstract
Global evidence indicates that transgender people are disproportionately at risk for HIV infection. However, limited data are available characterizing sexual behaviors and HIV infection among transgender people in Iran. This study aims to determine the prevalence of high-risk sexual behaviors and HIV infection among transgender people in Iran. In 2009, we assessed data of 58 transgender individuals (41 female-to-male (FTM) and 17 male-to-female (MTF)). Their demographic characteristics and risky sexual behaviors, and other risky behaviors such as substance use were gathered using a structured questionnaire. Rapid tests were used to confirm HIV seropositivity. Fifty-four participants who provided blood samples, none were positive (exact 95% confidence intervals: 0.0, 0.07). 75.6% of FTM and 64.7% of MTF reported having sex in the past six months, respectively. Of the sample who reported having sex in the past six months (n=42), only 19% reported using condoms. No participants reported a history of injection. In this study of HIV infection among a small sample of transgender people in Iran, no one was HIV positive. Some reasons for these findings can be outlined as a lack of history of intravenous drug use and related behaviors, limited high-risk relationships and behaviors, and the limited number of males among the samples.
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27. Khan AA, Rehan N, Qayyum K, Khan A. Correlates and prevalence of HIV and sexually transmitted infections among Hijras (male transgenders) in Pakistan. Int J STD AIDS 2008;19:817-20.
28. Pisani E, Girault P, Gultom M, Sukartini N, Kumalawati J, Jazan S, et al. HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia. Sex Transm Infect 2004;80:536-40.
29. Gama A, Martins MRO, Mendão L, Barros H, Dias S. HIV Infection, risk factors and health services use among male-to-female transgender sex workers: a cross-sectional study in Portugal. AIDS care 2018;30:1-8.
2. Collin L, Reisner SL, Tangpricha V, Goodman M. Prevalence of transgender depends on the "case" definition: a systematic review. J Sex Med 2016;13:613-26.
3. Zucker KJ. Epidemiology of gender dysphoria and transgender identity. Sex Health 2017;14:404-11.
4. Ahmadzad-Asl M, Jalali AH, Alavi K, Naserbakht M, Taban M, Mohseninia-Omrani K, et al. The Epidemiology of Transsexualism in Iran. J Gay Lesbian Ment Health 2010;15:83-93.
5. Baral SD, Poteat T, Strömdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis 2013;13:214-22.
6. Bauer GR, Travers R, Scanlon K, Coleman TA. High heterogeneity of HIV-related sexual risk among transgender people in Ontario, Canada: a province-wide respondent-driven sampling survey. BMC Public Health 2012;12:292.
7. Poteat T, Scheim A, Xavier J, Reisner S, Baral S. Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People. J Acquir Immune Defic Syndr 2016;72:S210-9.
8. Herbst JH, Jacobs ED, Finlayson TJ, McKleroy VS, Neumann MS, Crepaz N, et al. Estimating HIV Prevalence and Risk Behaviors of Transgender Persons in the United States: A Systematic Review. AIDS Behav 2008;12:1-17.
9. Van Gerwen O, Muzny C, Austin E, Musgrove K, Jani A. 784 Prevalence of STIs and HIV in transgender women and men: a systematic review. Sex Transm Infect 2019;95:A335
10. Moayedi-Nia S, Taheri L, Rouzbahani NH, Rasoolinejad M, Nikzad R, Ardebili ME, et al. HIV Prevalence and Sexual Behaviors Among Transgender Women in Tehran, Iran. AIDS Behav 2019;23:1590-3.
11. Operario D, Soma T, Underhill K. Sex work and HIV status among transgender women: systematic review and meta-analysis. J Acquir Immune Defic Syndr 2008;48:97-103.
12. Nemoto T, Bödeker B, Iwamoto M, Sakata M. Practices of receptive and insertive anal sex among transgender women in relation to partner types, sociocultural factors, and background variables. AIDS Care 2014;26:434-40.
13. Reisner SL, Murchison GR. A global research synthesis of HIV and STI biobehavioural risks in female-to-male transgender adults. Glob Public Health 2016;11:866-87.
14. de Lind van Wijngaarden JW, Schunter BT, Iqbal Q. Sexual abuse, social stigma and HIV vulnerability among young feminised men in Lahore and Karachi, Pakistan. Cult Health Sex 2013;15:73-84.
15. Sevelius JM. Gender affirmation: A framework for conceptualizing risk behavior among transgender women of color. Sex Roles 2013;68:675-89.
16. Merghati-Khoei ES, Rezaei Z, Shojaei-Zadeh D, Azadi NA, Rimaz S, Bayat A, et al. Sexual risk behaviors and condom use barriers in Iranian men with substance use disorders. Addict Health 2017;9:40.
17. Grarmaroudi GR, Makarem J, Alavi SS, Abbasi Z. Health related risk behaviors among high school students in Tehran, Iran. Health Monit J Iran Inst Health Sci Res 2010;9:13-9.
18. Hernandez AL, Lindan CP, Mathur M, Ekstrand M, Madhivanan P, Stein ES, et al. Sexual behavior among men who have sex with women, men, and Hijras in Mumbai, India—multiple sexual risks. AIDS Behav 2006;10:5-16.
19. Altaf A, Zahidie A, Agha A. Comparing risk factors of HIV among hijra sex workers in Larkana and other cities of Pakistan: an analytical cross sectional study. BMC public health 2012;12:279.
20. Emmanuel F, Salim M, Akhtar N, Arshad S, Reza TE. Second-generation surveillance for HIV/AIDS in Pakistan: results from the 4th round of Integrated Behavior and Biological Survey 2011–2012. Sex Transm Infect 2013;89:iii23-8.
21. Ramakrishnan L, Goswami P, Subramaniam T, Mathew S, Ramanathan S, George B, et al. Transgender in Tamil Nadu are still highly vulnerable to HIV and STIs: findings from bio-behavioral surveys. J Int AIDS Soc 2012;15:154-5.
22. Clements-Nolle K, Marx R, Guzman R, Katz M. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention. Am J Public Health 2001;91:915-21.
23. Schulden JD, Song B, Barros A, Mares-DelGrasso A, Martin CW, Ramirez R, et al. Rapid HIV testing in transgender communities by community-based organizations in three cities. Public Health Rep 2008;123:101-14.
24. Piot P. AIDS: from crisis management to sustained strategic response. Lancet 2006;368:526-30.
25. Global AIDS Monitoring 2020, UNAIDS epidemiological estimates, 2020 Unaids. (Accessed at https://www.unaids.org/en/regionscountries/countries/islamicrepublicofiran.)
26. Islamic Republic of Iran AIDS Progress Report, National AIDS Committee Secretariat. Ministry of Health and Medical Education, 2015.
27. Khan AA, Rehan N, Qayyum K, Khan A. Correlates and prevalence of HIV and sexually transmitted infections among Hijras (male transgenders) in Pakistan. Int J STD AIDS 2008;19:817-20.
28. Pisani E, Girault P, Gultom M, Sukartini N, Kumalawati J, Jazan S, et al. HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia. Sex Transm Infect 2004;80:536-40.
29. Gama A, Martins MRO, Mendão L, Barros H, Dias S. HIV Infection, risk factors and health services use among male-to-female transgender sex workers: a cross-sectional study in Portugal. AIDS care 2018;30:1-8.
| Files | ||
| Issue | Vol 59, No 2 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v59i2.5578 | |
| Keywords | ||
| Human immunodeficiency viruses (HIV) Transgender Risky behaviors Iran Acquired immunodeficiency syndrome (AIDS) | ||
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How to Cite
1.
Jalali Nadoushan A, Bahramian A, Taban M, Alavi K, Sharifi H, Shokoohi M, Eftekhar Ardebili M. High-Risk Sexual Behaviors Among Transgender Individuals in Tehran, Iran. Acta Med Iran. 2021;59(2):113-117.
