HIV prevalence among men and transgender sex workers in Spain
M. Diez1, F. Sanchez1, I. Pueyo2, J. del Romero3, I. Sanz4, M.L. Junquera5, M.C. Landa6, M.E. Lezaun7, M.M. Cámara8, J. Belda9, F.J. Bru10, J.A. Varela11, J.R. Ordoñana12, M.A. Azpiri13, J. Balaguer14, M. Vall15, I. Alastrue16, L. Gomez17, C. de Armas18, J.M. Ureña19, J. Trullén20, A. Diaz1, EPI-VIH Study Group
1Instituto de Salud Carlos III, HIV Epidemiology Unit, Madrid, Spain, 2Centro ETS, Sevilla, Spain, 3Centro Sanitario Sandoval, Madrid, Spain, 4Plan del Sida Pais Vasco, San Sebastian, Spain, 5Hospital Monte Naranco, Oviedo, Spain, 6CAM Iturrama, Pamplona, Spain, 7Servicio Epidemiologia, Logroño, Spain, 8Servicio infecciosas, Bilbao, Spain, 9Centro Informacion y Prevención del Sida, Alicante, Spain, 10Centro ETS Ayuntamiento Madrid, Madrid, Spain, 11Centro ETS, Gijón, Spain, 12Facultad de Psicología, Murcia, Spain, 13Consulta VIH, Vitoria, Spain, 14Centro ETS, Cartagena, Spain, 15CAPS Drassanes, Barcelona, Spain, 16Centro de Informacion y Prevencion del SIDA, Valencia, Spain, 17Servicio de Epidemiología, Santander, Spain, 18Centro Dermatologico, Tenerife, Spain, 19Centro de ETS y Orientación Sexual, Granada, Spain, 20Centro de Informacion y Prevencion del SIDA, Castellón, Spain
Background: To describe HIV prevalence and associated variables among men and transgender sex workers.
Methods: Men and transgender sex workers undergoing HIV testing in 19 HIV/Sexually Transmitted Infections clinics, located in Spain´s main cities, during the period 2000-2007 were prospectively identified. Epidemiological data as well as testing results were collected. HIV prevalence was calculated. The odds ratio and its 95% confidence interval (OR, 95%CI) was the measure of association. Logistic regression was used for the multivariate analysis.
Results: In total 1935 men and transgender sexual workers were identified. Mean age was 29.7 years (SD: 7.8) and 1362 were born outside Spain, Latin America being the most represented region. Of the study population, 1210 (63.9%) referred having sex exclusively with men, 221 (11.7%) exclusively with women and 462 (24.4%) reported sex with both. A total of 80 recalled sex with an HIV(+) partner, 43 were drugs injectors/ex-injectors and 908 have been tested previously in the same centre.
Global HIV prevalence was 9.9%. Prevalence was higher among transgender people (16.0%), Latin-Americans (13.4%), those tested for the first time (14.9% vs. 4.2% among repeat testers), and those who were homosexual or bisexual as compared to the heterosexuals (12.1%, 8.2% and 2.7% respectively).
In the multivariate analysis HIV prevalence was associated with: having 25-29 years (OR:1.7, 95%CI:1-2.6) or 30-34 years (OR:1.8, 95%CI:1.1-3.0); being Latin-American (OR:1.9, 95%CI:1.2-3.1); having had sex with an HIV(+) partner (OR:2.6, 95%CI:1.3-5.3); being homosexual (OR:4.8, 95%CI:1,9-11.8) or bisexual (OR:3.0, 95%CI:1.2-7.6) vs. being heterosexual; being transgender (OR:1.6, 95%CI:1.1-2.3); and testing for the first time vs. being a repeat tester (OR:5.0, 95%CI:3.3-7.5)
Conclusions: Specific HIV prevention strategies aiming at male and transgender sex workers, in particular Latin-American, transgender and homosexual people, should be implemented in Spain.
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