Study of prevalence of sexually transmitted infections/human immunodeficiency virus and condom use among male-to-female transgender: A retrospective analysis from a tertiary care hospital in Chennai

CONTEXT: A “Transgender” person is one who dresses as, desires to be, has undergone surgery to become or identifies with opposite sex. They have a higher risk of sexually transmitted infection (STI) due to a combination of biological and social reasons. They have risky sexual behaviors but low-risk perception. AIMS: The aim of this study is to determine the prevalence of STI/human immunodeficiency virus (HIV) in transgender (TG) and association with condom use. SETTINGS AND DESIGN: A retrospective study of 82 male-to-female TGs attending our sexually transmitted disease (STD) clinic from 2011 to 2014 was undertaken. SUBJECTS AND METHODS: Detailed history including sexual exposure, high-risk practices, and condom usage was obtained, and clinical examination for any evidence of STI was done. They were screened for the presence of STI/HIV and other appropriate investigations were done whenever required. STATISTICAL ANALYSIS USED: Retrospective analysis was used. RESULTS: In our study, the total prevalence of STI/HIV in the studied population was 48.8% which was considerably higher than the prevalence in the general population which was 5.4%. Promiscuity rate of TGs studied was 45%, 33% of them were male sex workers. Syphilis was the most common STD, followed by HIV, genital warts, and gonorrhea. The prevalence of condom use was 45.1%, and the prevalence of STI/HIV in the condom used TGs was 14.6%. CONCLUSION: Based on the above findings, the TG group is found to have a higher prevalence of HIV/STI despite the higher use of condoms which is mostly attributable to the lack of correct and consistent use of condoms. This stresses upon the importance of promoting the condom usage and knowledge, and also this group should be the focus of intensive intervention programs aimed at STI screening and treatment, reduction of risky sexual behavior, and promotion of HIV counseling and testing.