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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