Characterizing the HIV risks and potential pathways to HIV infection among transgender women in Côte d'Ivoire, Togo and Burkina Faso
نویسندگان
چکیده
INTRODUCTION Transgender women are at high risk for the acquisition and transmission of HIV. However, there are limited empiric data characterizing HIV-related risks among transgender women in sub-Saharan Africa. The objective of these analyses is to determine what factors, including sexual behaviour stigma, condom use and engagement in sex work, contribute to risk for HIV infection among transgender women across three West African nations. METHODS Data were collected via respondent-driven sampling from men who have sex with men (MSM) and transgender women during three- to five-month intervals from December 2012 to October 2015 across a total of six study sites in Togo, Burkina Faso and Côte d'Ivoire. During the study visit, participants completed a questionnaire and were tested for HIV. Chi-square tests were used to compare the prevalence of variables of interest between transgender women and MSM. A multilevel generalized structural equation model (GSEM) was used to account for clustering of observations within study sites in the multivariable analysis, as well as to estimate mediated associations between sexual behaviour stigma and HIV infection among transgender women. RESULTS In total, 2456 participants meeting eligibility criteria were recruited, of which 453 individuals identified as being female/transgender. Transgender women were more likely than MSM to report selling sex to a male partner within the past 12 months (p<0.01), to be living with HIV (p<0.01) and to report greater levels of sexual behaviour stigma as compared with MSM (p<0.05). In the GSEM, sexual behaviour stigma from broader social groups was positively associated with condomless anal sex (adjusted odds ratio (AOR)=1.33, 95% confidence interval (CI)=1.09, 1.62) and with selling sex (AOR=1.23, 95% CI=1.02, 1.50). Stigma from family/friends was also associated with selling sex (AOR=1.42, 95% CI=1.13, 1.79), although no significant associations were identified with prevalent HIV infection. CONCLUSIONS These data suggest that transgender women have distinct behaviours from those of MSM and that stigma perpetuated against transgender women is impacting HIV-related behaviours. Furthermore, given these differences, interventions developed for MSM will likely be less effective among transgender women. This situation necessitates dedicated responses for this population, which has been underserved in the context of both HIV surveillance and existing responses.
منابع مشابه
HIV prevalence and behavioral and psychosocial factors among transgender women and cisgender men who have sex with men in 8 African countries: A cross-sectional analysis
INTRODUCTION Sub-Saharan Africa bears more than two-thirds of the worldwide burden of HIV; however, data among transgender women from the region are sparse. Transgender women across the world face significant vulnerability to HIV. This analysis aimed to assess HIV prevalence as well as psychosocial and behavioral drivers of HIV infection among transgender women compared with cisgender (non-tran...
متن کاملDistribution of organophosphate and carbamate resistance in Culex pipiens quinquefasciatus (Diptera: Culicidae) in West Africa.
The distribution of organophosphate and carbamate resistance was investigated in 33 samples of Culex pipiens quinquefasciatus Say from 25 cities in Côte d'Ivoire and Burkina Faso. Organophosphate resistance levels were higher in Côte d'Ivoire than in Burkina Faso. Chlorpyrifos resistance ratios at LC95 ranged from 4 to 30 times in Côte d'Ivoire and from 3 to 6 times in Burkina Faso. For temepho...
متن کاملSafer Conception Needs for HIV Prevention among Female Sex Workers in Burkina Faso and Togo
BACKGROUND Reproductive health programming for female sex workers (FSW) may include contraceptive services but rarely addresses safer pregnancy planning. METHODS Adult FSW were enrolled into a cross-sectional study across four sites in Burkina Faso and Togo using respondent-driven sampling. Sociobehavioral questionnaires and HIV counseling and testing were administered. Sample statistics and ...
متن کاملDetermination and Characterization of Women, Infants, and Young Children\'s Dietary Diversity in Agricultural Mitigation Period of Burkina Faso
Backgroun: The increasing variety of foods and food groups in the diet helps to ensure adequate intake of essential nutrients and promotes good health. The main objective was to determine the diet quality of women, infants, and young children in agricultural mitigation period of Burkina Faso. Methods: A 24-h dietary open recall was used to collect all foods taken by women, infants, and young ch...
متن کاملRisk Factors for Neonatal Mortality at St Camille Hospital in Ouagadougou, Burkina Faso
Background: Neonatal mortality remains a public health concern in developing countries such as Burkina Faso. Improving the survival rate of newborns requires a good knowledge of the current situation. This study aimed at determining the risk factors for neonatal mortality in the Neonatology Department of Saint Camille Hospital of Ouagadougou (HOSCO - Hôpital Saint ...
متن کامل