HIV prevalence and demographic determinants of condomless receptive anal intercourse among trans feminine individuals in Beirut, Lebanon.

Publisher: John Wiley & Sons, Inc Country of Publication: Switzerland NLM ID: 101478566 Publication Model: eCollection Cited Medium: Internet ISSN: 1758-2652 (Electronic) Linking ISSN: 17582652 NLM ISO Abbreviation: J Int AIDS Soc Subsets: MEDLINE

Publication: 2017- : Hoboken, NJ : John Wiley & Sons, Inc
Original Publication: [London] : BioMed Central

Sexual Behavior*/statistics & numerical data ; Transgender Persons*; HIV Infections/*epidemiology ; HIV Infections/*transmission; Adult ; Female ; Humans ; Lebanon/epidemiology ; Logistic Models ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Risk-Taking ; Self Report ; Sex Work ; Sexual Partners ; Surveys and Questionnaires ; Young Adult

Introduction: Growing evidence suggests increased HIV incidence in the Middle East and North Africa among "key populations." To date, epidemiological data have not accurately included and measured HIV prevalence and risk among trans feminine individuals in the region. Through the lens of the Gender Affirmation Framework, we assessed demographic correlates of risk behaviour and the prevalence of HIV among trans feminine individuals in Lebanon.
Methods: Long-chain referral sampling was used to recruit 53 participants for completion of a behavioural survey and optional free rapid HIV tests. Data were collected using interviewer-administered questionnaires. A multivariable logistic regression model was used to identify demographic determinants of HIV risk behaviour.
Results: Fifty-seven percent of participants reported condomless receptive anal intercourse (CRAI) with male partner(s) in the last three months, 40% of whom reported not knowing the HIV status of the partner(s). Of the participants tested for HIV as part of the study or via self-report, four (10%) were HIV positive; 13 declined HIV testing. Forty percent of the sample had no prior history of HIV testing. A history of trauma such as sexual abuse/assault was reported by almost half of the participants (49%). Sixty-eight percent reported experiencing physical violence and 32% police arrest, because of gender identity or presentation. A staggering 98% reported having experienced gender identity or gender presentation-related discrimination. Sixty-six percent of the sample reported current sex work; sex work was correlated with CRAI but was not significant in multivariate analysis. In regression analysis, "openness"/"outness" about transgender identity at work or school was significantly associated with CRAI. Surprisingly, a history of sexual abuse/assault was negatively correlated with CRAI, suggesting the need for further inquiry.
Conclusions: The results of this study provide implications for how to address sexual health among trans feminine individuals in Lebanon and the greater Middle East and North Africa region.

Am J Public Health. 2001 Jun;91(6):915-21. (PMID: 11392934)
Psychol Bull. 2003 Sep;129(5):674-97. (PMID: 12956539)
AIDS Educ Prev. 2005 Oct;17(5):430-43. (PMID: 16255639)
AIDS Behav. 2008 Jan;12(1):1-17. (PMID: 17694429)
J Acquir Immune Defic Syndr. 2008 May 1;48(1):97-103. (PMID: 18344875)
AIDS Behav. 2008 Jul;12(4 Suppl):S93-6. (PMID: 18389358)
Public Health Rep. 2008 Nov-Dec;123 Suppl 3:101-14. (PMID: 19166094)
AIDS Behav. 2009 Oct;13(5):902-13. (PMID: 19199022)
AIDS. 2010 Jul;24 Suppl 2:S45-54. (PMID: 20610948)
AIDS Behav. 2011 Apr;15(3):674-82. (PMID: 20740376)
AIDS Care. 2012;24(2):210-9. (PMID: 21780964)
PLoS Med. 2010 Aug;8(8):e1000444. (PMID: 21829329)
J Assoc Nurses AIDS Care. 2012 Jul-Aug;23(4):306-17. (PMID: 22079675)
BMC Public Health. 2012 Apr 20;12:292. (PMID: 22520027)
Lancet Infect Dis. 2013 Mar;13(3):214-22. (PMID: 23260128)
Sex Roles. 2013 Jun 1;68(11-12):675-689. (PMID: 23729971)
AIDS Patient Care STDS. 2013 Nov;27(11):621-7. (PMID: 24138486)
J Trauma Dissociation. 2014;15(2):169-83. (PMID: 24313294)
Health Care Women Int. 2015;36(8):917-35. (PMID: 24588138)
Int J Infect Dis. 2014 May;22:11-5. (PMID: 24594310)
Arch Sex Behav. 2014 May;43(4):779-88. (PMID: 24752791)
Soc Sci Med. 2015 Dec;147:222-31. (PMID: 26599625)
Int J Transgend. 2016;17(1):23-30. (PMID: 27616943)

R21 MH093204 United States MH NIMH NIH HHS

Keywords: CRAI; HIV prevalence; Lebanon; Middle East and North Africa (MENA); URAI; trans feminine; transgender

Date Created: 20160720 Date Completed: 20170829 Latest Revision: 20190111

20240829

PMC4949314

10.7448/IAS.19.3.20787

27431468