The Interactions Between Vulnerabilities for HIV and Syphilis among Cisgender and Transgender People Who Use Drugs

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The Interactions Between Vulnerabilities for HIV and Syphilis among Cisgender and Transgender People Who Use Drugs

By FYH News Team

Published on November 14, 2022

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doi: 10.1007/s10508-022-02460-y.

Online ahead of print.

Affiliations

¹ Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil. ariadnerf@gmail.com.
² The Joint United Nations Program on HIV/AIDS, UN HOUSE Conjunto C, Quadra 802, Lote 17, Federal District, Brasília, 70800-400, Brazil. ariadnerf@gmail.com.
³ CAMH – Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
⁴ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁵ Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
⁶ Reference and Training Center for STI and AIDS, Sao Paulo State Secretariat of Health, Sao Paulo, SP, Brazil.
⁷ Department of Psychiatry, Queen’s University School of Medicine, Kingston, ON, Canada.
⁸ Reference Center for Alcohol, Tobacco and Other Drugs, Sao Paulo State Secretariat of Health, Sao Paulo, SP, Brazil.

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Ariadne Ribeiro et al.

Arch Sex Behav.

2022.

doi: 10.1007/s10508-022-02460-y.

Online ahead of print.

Affiliations

¹ Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil. ariadnerf@gmail.com.
² The Joint United Nations Program on HIV/AIDS, UN HOUSE Conjunto C, Quadra 802, Lote 17, Federal District, Brasília, 70800-400, Brazil. ariadnerf@gmail.com.
³ CAMH – Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
⁴ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁵ Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
⁶ Reference and Training Center for STI and AIDS, Sao Paulo State Secretariat of Health, Sao Paulo, SP, Brazil.
⁷ Department of Psychiatry, Queen’s University School of Medicine, Kingston, ON, Canada.
⁸ Reference Center for Alcohol, Tobacco and Other Drugs, Sao Paulo State Secretariat of Health, Sao Paulo, SP, Brazil.

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Abstract

In Brazil, transgender people are most affected by HIV, and crack cocaine addiction may contribute to social vulnerability and exposure to sexual and violence-related risks. This cross-sectional study comprised 2393 individuals seeking addiction treatment, consisting of 43 trans women, 1995 cisgender men, and 355 cisgender women. Records of rapid test results for HIV and syphilis and screening responses of trans women were compared to both cisgender groups using a logistic regression model to identify associated risk factors. HIV prevalence was higher in the transgender group (39.5%) than in cis women and men (5.9% and 3.6%, respectively). Our study showed an eightfold higher chance of a positive HIV test among transgender individuals who used drugs (OR: 8.79, p < .01, 95% CI: 3.90-19.78) compared to cisgender people who used drugs. A lifetime history of syphilis infection was more common in transgender people (60.0%) and cis women (32.8%) than in cis men (9.5%). Active syphilis was also more common in the transgender population (OR: 5.46, p < .01, 95% CI: 2.63 11.32). In our sample, 44.2% of transgender individuals had a history of at least one suicide attempt in their lifetime. Our results showed that transgender women were at higher risk of crack cocaine use (OR: 5.51, p < .01, 95% CI: 2.16-14.06) than cisgender men and women. The study showed that trans women had a higher prevalence of syphilis and HIV, and a greater chance of being homeless. The synergy of these vulnerabilities may have led to our findings of high psychotic symptoms and a history of suicide attempts in transgender individuals.

Keywords:

Crack cocaine; Gender identity; HIV; STI; Social determinants of health; Transgender.

References

1. Abdalla, R. R., Madruga, C. S., Ribeiro, M., Pinsky, I., Caetano, R., & Laranjeira, R. (2014a). Prevalence of cocaine use in Brazil: Data from the II Brazilian National Alcohol and Drugs Survey (BNADS). Addictive Behavior, 39(1), 297–301. https://doi.org/10.1016/j.addbeh.2013.10.019
  
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1. Baptista, C. J., Dourado, I., de Andrade, T. M., Brignol, S., Bertoni, N., & Bastos, F. I. (2017). HIV prevalence, knowledge, attitudes, and practices among polydrug users in Brazil: A biological survey using respondent driven sampling. AIDS and Behavior, 22(7), 2089–2103. https://doi.org/10.1007/s10461-017-1812-8
  
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1. Barrington, C., Wejnert, C., Guardado, M. E., Nieto, A. I., & Bailey, G. P. (2012). Social network characteristics and HIV vulnerability among transgender persons in San Salvador: Identifying opportunities for HIV prevention strategies. AIDS and Behavior, 16(1), 214–224. https://doi.org/10.1007/s10461-011-9959-1
  
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  PubMed
1. Bastos, F. I., Bastos, L. S., Coutinho, C., Toledo, L., Mota, J. C., Velasco-de-Castro, C. A., Sperandei, S., Brignol, S., Travassos, T. S., Dos Santos, C. M., & Malta, M. S. (2018). HIV, HCV, HBV, and syphilis among transgender women from Brazil: Assessing different methods to adjust infection rates of a hard-to-reach, sparse population. Medicine, 97(1S Suppl 1), 1S16-s24. https://doi.org/10.1097/MD.0000000000009447
  
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1. Bastos, F. I. P. M., Vasconcellos, M. T. L. d., De Boni, R. B., Reis, N. B. d., & de Souza Coutinho, C. F. (2017). III levantamento nacional sobre o uso de drogas pela população Brasileira. Rio de Janeiro: ICICT/FIOCRUZ. Retrieved from https://www.arca.fiocruz.br/handle/icict/34614

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