XVIII International AIDS Conference


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Transvestites in North East Brazil: high vulnerability to HIV infection

R. Gondim1, T. Martins2, L. Kerr1, H. Macena3, R. Mota1, K. Carneiro1, C. Kendall4

1Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, Brazil, 2Secretaria de Saúde do Estado do Ceara, Fortaleza/CE, Brazil, 3Universidade Federal do Ceará, Fortaleza, Brazil, 4Tulane University School of Public Health and Tropical Medicine, New Orleans, United States

Background: Transvestites are a population considered vulnerable to HIV/AIDS. Few studies report risk behaviors among this population in Brazil.
Methods: A cross-sectional study was conducted among 304 transvestites who reported sex with a man in the last 6 months. They were recruited using respondent driven sampling in Ceará State in 2008. Socio-demographic and risk behaviors that increase the risk of HIV infection were characterized. Data were analyzed with RDSAT, 5.6.
Results: Most of the participants identified as mixed race (“Parda” - 59%), were adults (51% > 24 years of age), had low levels of education (55% - elementary school only) and were low social class (62% of classes C, D, E). Most live with their families (49%), friends and a special category called “cafetina” (22%). Cafetinas are transvestites who organize a house and often play the role of Madam. Most respondents reported some kind of violence perpetrated against them (61%), especially due to homophobia (91% of all violence) and had an early sexual debut (56% - 10 to 14 years of age). They reported regular (54%), casual (63%) and female partners (26%) in their lifetime. Unprotected intercourse occurs in both homosexual (47%) and heterosexual relationships (43%) with frequent use of drugs during sexual encounters (43%). Prostitution is common (82% had received money for sex), with many clients (59% > 10 partners during the last 12 months) and low cost for sex (median= US$22,34, mean= US$36,81, sd= US$55,49 - US$0,53=). The majority refused to take the HIV test offered (65%) but reported having been tested and knew their serostatus (69% took the test at least once in their lifetime and 38% during the previous year).
Conclusions: This population is extremely poor educated and especially vulnerable to both social discrimination and HIV. Special programs and policies need to be addressed to them.

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