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Understanding the HIV/AIDS Epidemic in Transgender Women of Lima, Peru: Results from a Sero-Epidemiologic Study Using Respondent Driven Sampling

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Abstract

In Latin America, transgender women (transwomen or male to female transgenders) have been included in MSM research but without addressing their specific needs in terms of the HIV/AIDS. We present results of the first seroepidemiologic study designed for transwomen in Peru. We conducted a study using respondent driven sampling to recruit transwomen from Lima. Our survey explored sociodemographic characteristics, gender enhancement procedures and sexual behavior. In addition, we conducted laboratory based HIV, genital herpes (HSV2) and syphilis testing. A total of 450 transwomen were recruited between April and July 2009. HIV prevalence was 30%, HSV2: 79% and syphilis: 23%. Sex-work was the main economic activity (64%). Gender enhancement procedures were reported by 70% of the population. Multivariable analysis showed HIV infection to be associated with being older than 35 recent, syphilis infection and HSV2 infection. Transwomen are the group most vulnerable to HIV/AIDS in Peru.

Resumen

En Latinoamérica, las mujeres trans (personas trans de masculino a femenino) han sido incluídas en la investigación con población HSH sin abordar sus necesidades específicas en relación a la epidemia de VIH/SIDA. Presentamos los resultados del primer estudio sero-epidemiológico diseñado para mujeres trans en el Perú. Utilizamos un diseño transversal con respondent driven sampling (RDS). Las características socio-demográficas de la población, los procesos de transformación del cuerpo y las conductas sexuales fueron exploradas a través de una entrevista. Se realizaron pruebas de laboratorio para VIH, herpes genital (HSV2) y sífilis. Un total de 450 mujeres trans fueron enroladas en Lima entre abril y junio del 2009. La prevalencia de VIH encontrada fue de 30%, HSV2: 79% y sífilis: 23%. El trabajo sexual fue la principal actividad económica reportada (64%). Los procesos de modificación del cuerpo fueron reportados por el 70% de la población. El análisis mutivariable asoció la infección por VIH a una edad mayor a 35 años, la infección reciente por sífilis y la infección con HSV2. Este estudio muestra que las mujeres trans constituyen la población con mayor vulnerabilidad al VIH en el Perú.

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Acknowledgments

This study was conducted in all its phases in collaboration with Red Trans Peru, an organization that brings together transwomen from across the country and performs important work to pursue the fulfillment of rights of transwomen. It would not have been possible to design the instrument or the logistics of a feasible study without the participation of the population, demonstrating the important synergy obtained in a horizontal work between academia and grassroots organizations in research processes. Study funded by amfAR, American Foundation for AIDS Research (Grant no. 107266-44-IAMM).

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Authors and Affiliations

  1. Unit of Health, Sexuality and Human Development, Cayetano Heredia University School of Public Health, Av. Armendariz 445, Lima 18, Peru

    Alfonso Silva-Santisteban, Ximena Salazar, Jana Villayzan, Segundo Leon & Carlos F. Caceres

  2. San Francisco Department of Public Health, San Francisco, CA, USA

    H. Fisher Raymond & Willi McFarland

  3. Red Trans Peru, Lima, Peru

    Jana Villayzan

Authors
  1. Alfonso Silva-Santisteban
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  2. H. Fisher Raymond
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  3. Ximena Salazar
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  5. Segundo Leon
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  6. Willi McFarland
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  7. Carlos F. Caceres
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Correspondence to Alfonso Silva-Santisteban.

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Silva-Santisteban, A., Raymond, H.F., Salazar, X. et al. Understanding the HIV/AIDS Epidemic in Transgender Women of Lima, Peru: Results from a Sero-Epidemiologic Study Using Respondent Driven Sampling. AIDS Behav 16, 872–881 (2012). https://doi.org/10.1007/s10461-011-0053-5

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  • DOI: https://doi.org/10.1007/s10461-011-0053-5

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