Sexual behaviors and vulnerability to sexually transmitted infections among transgender women in Iran

Springer Science and Business Media LLC - Tập 22 - Trang 1-8 - 2022
Azar Nematollahi1, Safoora Gharibzadeh2, Maryam Damghanian3, Saeid Gholamzadeh4,5, Farnaz Farnam6
1Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
2Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
3Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
4Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
5Shahid Beheshti University of Medical Sciences, Tehran, Iran
6Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

Tóm tắt

Transgender people are at serious risk for HIV infection and other sexually transmitted infections (STIs), they are four times more likely to experience HIV infection than the general population. The aim of this study was to assess sexual behaviors and vulnerability of transgender women to STIs including HIV. A cross-sectional study was conducted using convenient sampling from August 2019 to March 2020 in Iran at “Support center for Iranian transgender” and “Shiraz Forensic Medicine” where transgender individuals refer to follow the steps of gender affirmation. 127 transgender women participated in this study. A researcher-made questionnaire was applied for evaluating sexual behaviors, STIs and HIV. The mean age of participants and their age of sexual debut were 27.6 and 16.9, respectively. 92.1% of participants were single with experience of sex and 59.3% had one sex partner in the last 2 years. 96.9% of the participants were heterosexual with 67.2% reporting experiencing orgasm in at least 50% of their sexual intercourse. However, 42.5% reported sexual pain and the same percentage reported low or very low sexual satisfaction. About half of the participants used condoms occasionally during sex (48.7%) and the most important reason for not using condoms in most cases was not having a condom (37.9%). Some of participants had little knowledge of the symptoms (33.9%) and complications (44.1%) of STIs. Although 87.4% and 72.4% of participants had never been tested for a STI and HIV, 1.6% were HIV positive and 18.1% had a history of STIs. Also, 26% of people had undergone vaginoplasty and a significant association was observed between vaginoplasty with sexual satisfaction (p < 0. 01(. Some of transgender women in this study were involved in high-risk sexual behaviors while unaware of the signs and symptoms of STIs. Also, despite reaching orgasm in most of their sexual relationships, they had little sexual satisfaction that could probably be related to body dissatisfaction, and lack of vaginoplasty in the majority of them. The need for gender affirming surgeries and psychiatric interventions affecting body satisfaction was identified in this group.

Tài liệu tham khảo

Association AP. Defining transgender terms. Monit Psychol. 2018;49(8):32.

Nikkelen SW, Kreukels BP. Sexual experiences in transgender people: the role of desire for gender-confirming interventions, psychological well-being, and body satisfaction. J Sex Marital Ther. 2018;44(4):370–81. https://doi.org/10.1080/0092623X.2017.1405303.

Doorduin T, Van Berlo W. Trans people’s experience of sexuality in the Netherlands: a pilot study. J Homosex. 2014;61(5):654–72. https://doi.org/10.1080/00918369.2014.865482.

Cerwenka S, Nieder TO, Cohen-Kettenis P, De Cuypere G, Haraldsen IRH, Kreukels BP, et al. Sexual behavior of gender-dysphoric individuals before gender-confirming interventions: a European multicenter study. J Sex Marital Ther. 2014;40(5):457–71. https://doi.org/10.1080/0092623X.2013.772550.

Costantino A, Cerpolini S, Alvisi S, Morselli PG, Venturoli S, Meriggiola MC. A prospective study on sexual function and mood in female-to-male transsexuals during testosterone administration and after sex reassignment surgery. J Sex Marital Ther. 2013;39(4):321–35. https://doi.org/10.1080/0092623X.2012.736920.

Bungener SL, Steensma TD, Cohen-Kettenis PT, De Vries AL. Sexual and romantic experiences of transgender youth before gender-affirmative treatment. Pediatrics. 2017. https://doi.org/10.1542/peds.2016-2283.

Kundu M, Panda N, Chowdhury S, Basu R, Das D, Sonkar R, et al. P4. 114 sexual behavior and practice among transgenders in West Bengal, India. Sex Transm Infect. 2013;89(1):A323. https://doi.org/10.1136/sextrans-2013-051184.1011.

Wilson EC, Garofalo R, Harris DR, Belzer M. Sexual risk taking among transgender male-to-female youths with different partner types. Am J Public Health. 2010;100(8):1500–5. https://doi.org/10.2105/AJPH.2009.160051).

Nemoto T, Operario D, Keatley J, Villegas D. Social context of HIV risk behaviours among male-to-female transgenders of colour. AIDS Care. 2004;16(6):724–35. https://doi.org/10.1080/09540120413331269567.

Equality NCfT. Testimony of the National Center for Transgender Equality, U.S. House of Representatives—Committee on the Judiciary, Subcommittee on the Constitution, Civil Rights, and Civil Liberties, H.R. 5 “The Equality Act”—April 2, 2019. https://www.congress.gov.

Nematollahi A, Farnam F, Gharibzadeh S, Khoda-Khah P. Discrimination, violence, and suicide in transgender women in Iran. Health Care Women Int. 2021. https://doi.org/10.1080/07399332.2021.1920944.

Hines DD, Draucker CB, Habermann B. HIV testing and entry to care among trans women in Indiana. J Assoc Nurses AIDS Care. 2017;28(5):723–36. https://doi.org/10.1016/j.jana.2017.05.003.

Shankle M. The handbook of lesbian, gay, bisexual, and transgender public health: a practitioner’s guide to service. New York: Routledge; 2013.

Grant JM, Mottet LA, Tanis J, Herman JL, Harrison J, Keisling M. National transgender discrimination survey report on health and health care. Washington, DC: National Center for Transgender Equality and the National Gay and Lesbian Task Force; 2010.

Coleman EJ, Kirk S, Bockting WO. Transgender and HIV: risks, prevention, and care. New York: Routledge; 2014.

Lombardi EL, van Servellen G. Building culturally sensitive substance use prevention and treatment programs for transgendered populations. J Subst Abuse Treat. 2000;19(3):291–6. https://doi.org/10.1016/S0740-5472(00)00114-8.

Aghabikloo A, Bahrami M, Saberi SM, Emamhadi MA. Gender identity disorders in Iran; request for sex reassignment surgery. Int J Med Toxicol Forensic Med. 2012;2(4):128–34.

Javaheri F. A study of transsexuality in Iran. Iran Stud. 2010;43(3):365–77. https://doi.org/10.1080/00210861003693893.

Moayedi-Nia S, Taheri L, Rouzbahani NH, Rasoolinejad M, Nikzad R, Ardebili ME, et al. HIV prevalence and sexual behaviors among transgender women in Tehran, Iran. AIDS Behav. 2019;23(6):1590–3. https://doi.org/10.1007/s10461-018-02380-w.

Nematollahi, A., Farnam, F., Damghanian, M., Gharibzadeh, S., & Gholamzadeh, S. (2022). Quality of Life and Mental Health in Iranian Transgender Women. International Journal of Medical Toxicology and Forensic Medicine, 12(1), 35133. Retrieved from https://journals.sbmu.ac.ir/ijmtfm/article/view/35133.

Clements-Nolle K, Marx R, Guzman R, Katz M. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention. Am J Public Health. 2001;91(6):915. https://doi.org/10.2105/ajph.91.6.915.

Herbst JH, Jacobs ED, Finlayson TJ, McKleroy VS, Neumann MS, Crepaz N, et al. Estimating HIV prevalence and risk behaviors of transgender persons in the United States: a systematic review. AIDS Behav. 2008;12(1):1–17. https://doi.org/10.1007/s10461-007-9299-3.

Hashemi S, Seddigh S, Tehrani FR, Khansari SMH, Khodakarami N. Sexual behavior of married Iranian women, attending Taleghani public health center. J Reprod Infertil. 2013;14(1):34.

Farnam F, Raisi F, Janghorbani M, Merghati-Khoei E. How do Iranian women with sexual problems conceptualize sexuality? A qualitative research. Nurs Pract Today. 2016;3(3):107–15.

Sinha A, Goswami DN, Haldar D, Mallik S, Bisoi S, Karmakar PR. Sexual behavior of transgenders and their vulnerability to HIV/AIDS in an urban area of Eastern India. Indian J Public Health. 2017;61(2):141–3. https://doi.org/10.4103/ijph.IJPH_248_14.

Safarinejad M. Female sexual dysfunction in a population-based study in Iran: prevalence and associated risk factors. Int J Impot Res. 2006;18(4):382–95. https://doi.org/10.1038/sj.ijir.3901440.

Najafabady MT, Salmani Z, Abedi P. Prevalence and related factors for anorgasmia among reproductive aged women in Hesarak, Iran. Clinics. 2011;66(1):83–6. https://doi.org/10.1590/S1807-59322011000100015.

Merghati Khoei E, Maasoumi R, Talebi S, Hajimirzaie S, Bayat A, Rimaz S, et al. Factors affecting sexual satisfaction in Iranian women. Women’s Health Bull. 2015;2(4):1–4. https://doi.org/10.17795/WHB26604.

Dehghani Champiri F, Dehghani A. Predicting sexual satisfaction in Iranian women by marital satisfaction components. Sex Relationsh Ther. 2020. https://doi.org/10.1080/14681994.2020.1736279.

Fathi Aghdam G, Haghighat S, Dorri S, Nazeri N, Ajorbandian A. The comparison of sexual satisfaction and body image between women with breast cancer after treatment and healthy women. Iran Q J Breast Dis. 2018;11(2):46–55. https://doi.org/10.30699/acadpub.ijbd.11.2.46.

Marvi N, Golmakani N, Esmaily H, Shareh H. The relationship between sexual satisfaction and genital self-image in infertile women. J Midwifery Reprod Health. 2018;6(4):1468–75. https://doi.org/10.22038/JMRH.2018.21564.1233.

Van De Grift TC, Elaut E, Cerwenka SC, Cohen-Kettenis PT, De Cuypere G, Richter-Appelt H, et al. Effects of medical interventions on gender dysphoria and body image: a follow-up study. Psychosom Med. 2017;79(7):815.

Alizadeh A, Farnam F, Raisi F, Parsaeian M. Prevalence of and risk factors for genito-pelvic pain/penetration disorder: a population-based study of Iranian women. J Sex Med. 2019;16(7):1068–77. https://doi.org/10.1016/j.jsxm.2019.04.019.

Hessou S, Glele Ahanhanzo Y, Kpozehouen A, Biaou A, Yadouleton T, Sodoloufo O, et al. Knowledge and sexual behaviors of transgender individuals faced with the risk of STI/HIV in Benin: Yolaine Glele Ahanhanzo. Eur J Public Health. 2019;29(4):ckz186.665.

Johnson RB, Onwuegbuzie AJ. Mixed methods research: a research paradigm whose time has come. Educ Res. 2004;33(7):14–26. https://doi.org/10.3102/0013189X033007014.

Operario D, Nemoto T, Iwamoto M, Moore T. Unprotected sexual behavior and HIV risk in the context of primary partnerships for transgender women. AIDS Behav. 2011;15(3):674–82. https://doi.org/10.1007/s10461-010-9795-8.

Becasen JS, Denard CL, Mullins MM, Higa DH, Sipe TA. Estimating the prevalence of HIV and sexual behaviors among the US transgender population: a systematic review and meta-analysis, 2006–2017. Am J Public Health. 2019;109(1):e1–8.

Bhatta DN. HIV-related sexual risk behaviors among male-to-female transgender people in Nepal. Int J Infect Dis. 2014;22:11–5. https://doi.org/10.1016/j.ijid.2014.01.002.

Thông tin
Thông tin xuất bản

Springer Science and Business Media LLC

Tập 22

1-8

Thông tin tác giả