Prevalence of Human Immunodeficiency Virus and Sexually Transmitted Infections Among Cisgender and Transgender Women Sex Workers in Greater Kuala Lumpur, Malaysia: Results From a Respondent-Driven Sampling Study
Sex workers face a disproportionate burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STI) worldwide. For cisgender women sex workers (CWSW), global HIV prevalence is over 10%, whereas transgender women sex workers (TWSW) face an HIV burden of 19% to 27%. We used resp...
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Published in | Sexually transmitted diseases Vol. 44; no. 11; p. 663 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
01.11.2017
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Abstract | Sex workers face a disproportionate burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STI) worldwide. For cisgender women sex workers (CWSW), global HIV prevalence is over 10%, whereas transgender women sex workers (TWSW) face an HIV burden of 19% to 27%.
We used respondent-driven sampling to recruit 492 sex workers, including CWSW (n = 299) and TWSW (n = 193) in Greater Kuala Lumpur, Malaysia. Participants completed an in-depth survey and were screened for HIV, syphilis, Chlamydia trachomatis, and Neisseria gonorrhoeae. Sample characteristics stratified by gender identity and interview site are presented. Bivariate analyses comparing CWSW and TWSW were conducted using independent samples t tests for continuous variables and χ tests for categorical variables.
Pooled HIV prevalence was high (11.7%; 95% confidence interval [CI], 8.8-14.5), and was similar for CWSW (11.1%) and TWSW (12.4%). Rates of syphilis 25.5% (95% CI, 21.6-29.5), C. trachomatis (14.8%; 95% CI, 11.6-18.0) and N. gonorrhoeae (5.8%; 95% CI, 3.7-7.9) were also concerning. Both groups reported lifetime HIV testing (62.4%), but CWSW were less likely to have ever been HIV tested (54.5%) than TWSW (74.6%). Median time since last HIV test was 24 months. Previous screening for STI was low. Inconsistent condom use and drug use during sex work were not uncommon.
High HIV and STI prevalence, coupled with infrequent HIV and STI screening, inconsistent condom use, and occupational drug use, underscore the need for expanded HIV and STI prevention, screening, and treatment efforts among CWSW and TWSW in Malaysia. |
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AbstractList | Sex workers face a disproportionate burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STI) worldwide. For cisgender women sex workers (CWSW), global HIV prevalence is over 10%, whereas transgender women sex workers (TWSW) face an HIV burden of 19% to 27%.
We used respondent-driven sampling to recruit 492 sex workers, including CWSW (n = 299) and TWSW (n = 193) in Greater Kuala Lumpur, Malaysia. Participants completed an in-depth survey and were screened for HIV, syphilis, Chlamydia trachomatis, and Neisseria gonorrhoeae. Sample characteristics stratified by gender identity and interview site are presented. Bivariate analyses comparing CWSW and TWSW were conducted using independent samples t tests for continuous variables and χ tests for categorical variables.
Pooled HIV prevalence was high (11.7%; 95% confidence interval [CI], 8.8-14.5), and was similar for CWSW (11.1%) and TWSW (12.4%). Rates of syphilis 25.5% (95% CI, 21.6-29.5), C. trachomatis (14.8%; 95% CI, 11.6-18.0) and N. gonorrhoeae (5.8%; 95% CI, 3.7-7.9) were also concerning. Both groups reported lifetime HIV testing (62.4%), but CWSW were less likely to have ever been HIV tested (54.5%) than TWSW (74.6%). Median time since last HIV test was 24 months. Previous screening for STI was low. Inconsistent condom use and drug use during sex work were not uncommon.
High HIV and STI prevalence, coupled with infrequent HIV and STI screening, inconsistent condom use, and occupational drug use, underscore the need for expanded HIV and STI prevention, screening, and treatment efforts among CWSW and TWSW in Malaysia. |
Author | Wickersham, Jeffrey A Meyer, Jaimie P Bazazi, Alexander R Gibson, Britton A Pedersen, Courtney J Kamarulzaman, Adeeba Altice, Frederick L Pillai, Veena El-Bassel, Nabila Mayer, Kenneth H |
Author_xml | – sequence: 1 givenname: Jeffrey A surname: Wickersham fullname: Wickersham, Jeffrey A organization: From the Section of Infectious Diseases, AIDS Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT; †Faculty of Medicine, Department of Medicine, Centre of Excellence for Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia; ‡Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT; §Social Intervention Group, School of Social Work, Columbia University, New York, NY; and ¶The Fenway Institute, Fenway Health, Boston, MA; and ∥Beth Israel Deaconess Medical Center, Harvard Medical School, Harvard T.C. Chan School of Public Health, Boston, MA – sequence: 2 givenname: Britton A surname: Gibson fullname: Gibson, Britton A – sequence: 3 givenname: Alexander R surname: Bazazi fullname: Bazazi, Alexander R – sequence: 4 givenname: Veena surname: Pillai fullname: Pillai, Veena – sequence: 5 givenname: Courtney J surname: Pedersen fullname: Pedersen, Courtney J – sequence: 6 givenname: Jaimie P surname: Meyer fullname: Meyer, Jaimie P – sequence: 7 givenname: Nabila surname: El-Bassel fullname: El-Bassel, Nabila – sequence: 8 givenname: Kenneth H surname: Mayer fullname: Mayer, Kenneth H – sequence: 9 givenname: Adeeba surname: Kamarulzaman fullname: Kamarulzaman, Adeeba – sequence: 10 givenname: Frederick L surname: Altice fullname: Altice, Frederick L |
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SubjectTerms | Adult Aged Chlamydia Infections - epidemiology Condoms - statistics & numerical data Female Gonorrhea - epidemiology Health Knowledge, Attitudes, Practice HIV Infections - epidemiology Humans Malaysia - epidemiology Male Mass Screening - statistics & numerical data Middle Aged Prevalence Sampling Studies Sex Workers - statistics & numerical data Sexual Partners Substance-Related Disorders - epidemiology Syphilis - epidemiology Transgender Persons - statistics & numerical data Unsafe Sex - statistics & numerical data Young Adult |
Title | Prevalence of Human Immunodeficiency Virus and Sexually Transmitted Infections Among Cisgender and Transgender Women Sex Workers in Greater Kuala Lumpur, Malaysia: Results From a Respondent-Driven Sampling Study |
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