Cross-section study on prevalence on sexually transmitted infections including HIV/AIDS among Trans-women residing in Chennai, Tamil nadu
Trans-women (Aravanis/ male-to-female transgenders) are among the groups that are at high risk of contraction and transmission of HIV in India. A cross-sectional study was conducted to address existing knowledge gaps regarding prevalence of HIV and STIs and sexual behaviors and practices. The study, constituting the doctoral work of SAATHII’s Research Officer P.S. Saravanamurthy, was carried out in collaboration with SAATHII, the Tamil Nadu State AIDS Control Society (TANSACS) and the Institute of Basic Medical Sciences.
Specific objectives included:
- To study the sero-prevalence of STDs such as Syphilis, Hepatitis B virus, Hepatitis C virus, Herpes Simplex Virus (HSV) – 1 and 2, gonorrhea, Chlamydia and HIV among tans-women community residing in Chennai, Tamil Nadu.
- To study the sexual practices of trans-women residing in Chennai, Tamil Nadu.
- To study the non-sexual practices/behaviors that exist in the trans-women community that makes this community particularly vulnerable to STIs and HIV.
- To analyze and document the association between substance abuse and the sexual practices among the trans-women community residing in Chennai, Tamil Nadu.
- To analyze and document the association between sexual practices and prevalence of STIs and HIV among the trans-women community residing in Chennai, Tamil Nadu.
- To analyze the HIV positive samples, for the prevalence of mutant strains among the trans-women community residing in Chennai, Tamil Nadu.
A total of 131 trans-women, with an average age of 28, residing in Chennai were recruited for the study collecting socio-economic characteristics, education, occupation, sexual behaviors/ practices, knowledge on STIs and HIV, risk perceptions towards STIs and HIV, STIs and HIV prevalence and the prevalence of mutant HIV strains in this community.
Laboratory results showed a 17% HIV/AIDS prevalence rate among trans-women. Laboratory investigations revealed that 72% of the participants had at least one STI. 48% tested seropositive for HSV-1, 29% for HSV-2, and 7.8% for HBV. Of the 23 (17%) individuals diagnosed as HIV positive, only 4 had prior knowledge of their seropositivity. Among the bacterial STIs, 1.5% tested positive for gonorrhea, and 0.76% for Chlamydia. 5.4% of participants had syphilis and another 15.50% had had syphilis at one point or another in their lives. None of the study participants had Hepatitis C.
Many study participants reported practicing multi-partner sex with their life partners, casual partners and paid partners, or some combination. 29% of the study participants had sex with both casual and paid partners, 13% with life and paid partners and 9% with life and casual partners. 11% of the study participants reported only having sex with life partners, 8% of them only with casual partners, and 19% only with paid partners. The study participants predominantly practiced inter-femoral sex, followed by anal sex and oral sex. Condom usage was not consistent among the study participants. However, frequency of condom usage with paid partners was higher when compared to with casual and life partners.
Considering the high prevalence of HIV/AIDS among this community, and the prevalence pattern in other countries, the project recommended a community specific evidence-based intervention.