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Global Health Econ Sustain Transgenders HIV-related knowledge and risk behaviors

risk behavior data such as sexual identity (AMAB or 3. Results
AFAB), age, educational background, source of income,
engagement in professional sex work (yes or no), type of The study involved interviews with a total of 135
client in sex work (regular, irregular, both), mode of sexual transgender individuals aged 18 – 50. Among them,
activity (vaginal, anal, oral), use of barrier methods during 52.60% were from DIC (Badhon Hijra Songho), while the
sexual activity (always, occasionally, never, client’s desire, remaining 26.70%, 17.00%, and 3.70% originated from
Kamalapur Railway Field Center, Mohakhali Railgate Field
own desire), location of sexual activity, and duration of Center, and Rampura Bridge Field Center, respectively.
involvement in sex work. In addition, questions were According to the study’s findings, the average age of the
asked regarding substance use, experience of sexual abuse, respondents was 27.56 ± 7.889 years, with the majority
frequency of HIV testing, and sexual preferences (male, identifying as Muslims (92.60%) and Hindus (4.40%). The
female, or both).
survey revealed that 86 (63.70%) of the participants self-
2.4. HIV-KQ-18 identified as AMAB and 49 (36.30%) as AFAB. Moreover,
one-fourth of the 135 transgender individuals had
The HIV-KQ-18 instrument demonstrates reliability (good completed secondary education, nearly one-fourth had
internal consistency with Cronbach’s alpha values ranging finished elementary education, and 14.80% were degree
from 0.75 to 0.89). It is characterized by stability, sensitivity, graduates, while a considerable 16.30% had not received
and suitability for diverse populations, including those any formal education. In this study, the majority of
with limited literacy. To assess HIV knowledge, the transgender individuals reported that they were involved
HIV-KQ-18 (Carey & Schroder, 2002) was employed. in Cholla tola (collecting money as a group from markets
The questionnaire includes questions such as “A woman and streets) at 27.50%, Bandhigiri (entertaining one
can get HIV if she has anal sex with a man.” Responses sexually) at 0.40%, and over half of them (50.90%) engaged
were recorded as “true,” “false,” and “don’t know,” and in professional sex work.
higher scores indicate a higher level of HIV knowledge.
Erroneous responses, namely “do not know” and “refused Among the studied population, only 15.50% work
to respond,” were counted, for each correct response were in services, 8% in business, and 2.60% require financial
given score = 1, while for “do not know” or “refused to assistance from their family. A substantial 97.80% of the
respond” were given score = 0. population are professional sex workers, with almost half
having engaged in this profession for more than 10 years
2.5. Statistical analysis and nearly one-third for <5 years. The majority of the
In the current study, descriptive statistics, including transgender individuals (79.30%) were unmarried, while
frequency, percentage, means, and standard deviations, 20.70% were married. Sexual activity distribution varied,
were used. The Chi-square and t-tests were used to with more than one-third of the transgender individuals
investigate the association between variables. To highlight (33.30%) engaging in sexual activity at their own home,
the maximum impact of the result, a bivariate analysis that 26% in a client’s home, 22.70% on an open street, and just
included the Chi-square and t-test was initially conducted. 15.30% in a hotel. This study also revealed that 45.90% of
The study was conducted using SPSS version 26.0.0 (the respondents had anal sex, 41.20% had oral sex, and 12.90%
Statistical Package for the Social Science) software for had vaginal sex. Among the 135 transgender people
Windows (Mac OS) and the R statistical package. interviewed, 37.80% had experienced sexual assault, 22.70%
had been physically assaulted, 22.20% had faced verbal
2.6. Ethical considerations harassment, and 6.20% had no history of sexual assault.
The study received formal authorization from the National Detailed results, including sociodemographic variables
Institute of Preventive and Social Medicine (NIPSOM) and sexual risk behaviors among transgender individuals,
Institutional Review Board (IRB) (Memo No - NIPSOM/ are presented in Table 1. Among the respondents, 31%
IRB/2017/09). Before the commencement of the study, always use a barrier method during sexual activity, while
each respondent or participant was duly informed, and 37.30% sometimes use it, and only 10.80% never use any
their informed written consent was obtained. Participation barrier method. Furthermore, 17.70% of the respondents
in this study was entirely voluntary. The working hours of claim that their use of protection depends on the client’s
the responders remained constant, and due respect was desire. In addition, the use of pills, alcohol, and sex tablets
accorded to them, acknowledging their involvement and among transgender individuals was reported.
contributions. Following the completion of these stages, The average score of HIV-KQ-18 responses was 8.54
the questionnaires were distributed to them with their ± 3.90 out of 18, ranging from 0 to 18. When the scores
explicit permission. were divided into good knowledge and poor knowledge

Volume 2 Issue 1 (2024) 3 https://doi.org/10.36922/ghes.1643