Prevalence and Associated Risk Factors of HIV Infections in a Representative Sample of the Transgender and Non-Binary Population in Flanders and Brussels (Belgium)
21 Pages Posted: 24 Aug 2024
Abstract
Introduction: HIV prevalence and sexual risk have been estimated high in transgender people, especially in transgender women. However, current literature is limited in that people at high risk for HIV are potentially overrepresented. This study aimed at estimating HIV prevalence and associated risk factors in a large, representative sample of transgender and non-binary (TGNB) people in Belgium. Methods: A two-stage time-location random sampling (TLS) strategy was used to select and recruit participants. Clusters were randomly selected from a sampling frame based on a qualitative mapping of community and healthcare settings frequented by TGNB people. Within selected clusters, participants were randomly selected to complete an electronic self-reported survey to measure sociological, sexual, and other risk factors. Oral fluid samples were collected and tested for HIV antibodies. Logistic regression models were used to evaluate demographic characteristics associated with risk factors for HIV infection. Findings: From December 2021 to July 2023, 1068 participants were enrolled in the study. Based on seven positive out of 1033 samples, HIV prevalence was estimated at 0·4% (95% CI 0·07-1·3%). Identifying as transgender woman as well as visiting major events, sex work settings, and nightlife were significantly associated with high risk behavior for HIV infection (all OR≥1·65, all P<0·025), whereas having ever been in contact with a transgender healthcare provider acts as a protective factor for high risk behavior (OR=0·54, 95% CI 0·33-0·86%, P=0·011). Interpretation: Overall HIV prevalence was found to be low. Factors associated with high risk behavior that can inform policies, research, and future interventions were identified. Funding: Foundation for Scientific Research of the Belgian Red Cross, Institute for the Equality of Women and Men, University Fund Ghent University and Gilead Sciences.
Note:
Trial Registration Details: The study is registered at ClinicalTrials.gov (NCT04930614).
Funding Information: his work was made possible through funding from the Foundation for Scientific Research of the Belgian Red Cross (Mechelen, Belgium), the Institute for the Equality of Women and Men (Brussels, Belgium), University Fund Ghent University (Ghent, Belgium) and Gilead Sciences (Diegem, Belgium; Grant number: BE-2021-0049).
Declaration of Interests: All authors declare they have no competing interests.
Ethics Approval Statement: This study was approved by the Ghent University Hospital Ethics Committee on September 17, 2020 (BC-08157)and July 28, 2021 (BC-08527).
Keywords: HIV prevalence, sexual risk, transgender, non-binary
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