Transgender HIV and sexually transmissible infections

McNulty, A., & Bourne, C. (2017). Transgender HIV and sexually transmissible infections. Sexual Health.

Abstract. Transgender women across a range of different populations and settings have a high prevalence of HIV infection. There are fewer and often poorer quality studies of sexually transmissible infection (STI) prevalence. There are fewer studies in transgender men and, in general, the prevalence of HIV and STIs is lower than that of transgender women. Susceptibility to HIV and STI infection is inextricably linked to the increased vulnerability of transgender populations, a consequence of a lack of legal and social recognition that results in reduced access to educational and employment opportunities, which can result in high rates of transactional sex. Other measures of disadvantage, such as substance abuse and mental health problems, also increase the risk of HIV and STIs and have an effect on access to health care, highlighting the need for transgender-friendly multidisciplinary services offering individualised risk assessment, prevention advice and testing for STI and HIV.


Transgender is a term with a wide spectrum of meanings, but which generally refers to an individual’s gender identity or expression when it differs from their birth sex. Sociocultural factors play a significant role in the expression and understanding of transgender identity, and labels applied to gender categories can change over time.

So, understanding the epidemiology of sexually transmissible infections (STIs) and HIV among transgender people is limited by adequately defining the population and sampling biases.1 Compared with other groups, transgender women have been more often included in recent epidemiological HIV surveys of men who have sex with men (MSM), so there is more data about them than transgender men. Recent studies have highlighted that transgender men may be at particular risk of HIV and STIs if they are sexually active with men who have sex with men.

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