Assessment of oral mucosal lesions among HIV positive transgenders residing in Odisha with and without Antiretroviral therapy

PURPOSE/BACKGROUND: Transgenders are a highly vulnerable subset within the high-risk group for human immunodeficiency virus (HIV) in India. Oral manifestations are among the early signs of HIV infection. This study was conducted with the aim to assess the oral mucosal lesions among the HIV-positive transgenders in Odisha taking antiretroviral therapy as well as those not taking antiretroviral therapy. METHODS: A cross-sectional study was carried out among HIV-positive transgenders in four districts of Odisha. Snowball nonprobability sampling technique was adopted, and type IV clinical examination was performed using the modified WHO record form for oral manifestations in HIV/AIDS (2013). Independent sample t test was used to compare mean age among those taking ART with those not taking ART. Chi-square test was used to detect the associations among categorical variables. RESULTS: The study comprised of 163 participants, 109 (71.24%) who were taking antiretroviral therapy, while 44 (28.76%) not taking antiretroviral therapy. The mean age was 32.56 + 7.69 years. Sex work was the most predominant occupation. Majority of the participants reported of having hyperpigmentation of different parts of oral mucosa. Aphthous ulcer and angular cheilitis was noticed in 14.72% and 9.20%, respectively. Other manifestations noticed included erythematous candidiasis, pseudomembranous candidiasis, oral hairy leukoplakia, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis, herpetic stomatitis/gingivitis and/or labialis, herpes zoster, warty like lesions/human papillomavirus, other ulcerations (not otherwise specified/necrotizing ulcerative stomatitis), and dry mouth due to decreased salivary flow. CONCLUSION: Careful evaluation of oral manifestations can improve the quality of life of these marginalized, highly vulnerable population.