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

Table 1. Sociodemographic and sexual risk behavior of the that transgender individuals in the DIC possessed more
respondents HIV-related knowledge than transgender individuals in the
Hijra Pollis, and this difference was statistically significant
Sociodemographic and sexual Frequency (n) Percentage (%)
risk behavior‑related variable (t [95% CI] = 0.168 [0.1001 – 0.236], p < 0.001). All
Sexual identity inferential statistical tests are presented in Tables 3 and 4.
AMAB 86 63.7 4. Discussion
AFAB 49 36.3 4.1. Comparison with other studies
Marital status
Unmarried 107 79.3 In this study, despite the majority of transgender
Married 28 20.7 individuals exhibiting good knowledge regarding HIV,
they still engaged in sexual risk behaviors. The level of
Professional sex worker HIV-related knowledge was found to be associated with
Yes 132 97.8 their education attainment and other sociodemographic
No 3 2.2 characteristics. Despite possessing good knowledge
Duration of involvement in sex work regarding HIV, over half of the transgender individuals in
<5 years 39 28.9 the study reported having irregular sexual clients. Those
5 – 10 years 30 22.2 who had regular interactions with DIC exhibited higher
>10 years 66 48.9 levels of HIV-related knowledge than their counterparts.
Type of client in sex work Nonetheless, many participants perceived seeking HIV-
related health care to be somewhat difficult. It is noteworthy
Regular 12 8.9 that AFAB individuals face ostracization and denial of
Irregular 73 54.1 basic human rights, such as restricted access to health care
Both 50 37.0 (Reza et al., 2023).
Age of the respondents 135 27.56±7.889 year The study findings align with earlier studies,
Abbreviations: AFAB: Transgender-assigned female at birth; demonstrating how stigma, discrimination, abuse, and
AMAB: Transgender-assigned male at birth. societal barriers limit employment opportunities for
transgender individuals. These challenges force them
with a cut-off point of 47.44%, 77 (57%) of the transgender into traditional occupations, primarily engaging in sex
individuals demonstrated good knowledge, while work to fulfill their basic needs. In Bangladesh, 31% of
58 (43%) exhibited poor knowledge. The majority of transgender individuals are involved in sex work, and 51%
participants (91.90%) were aware that having multiple sex resort to begging (Harper, 2023). Similar investigations
partners increases the risk of contracting HIV (Item 14). have been conducted internationally. In Nepal, 76% of
In addition, a significant proportion (86.70%) was aware transgender individuals engage in sex work (Sarker, 2019),
that anal intercourse could be a mode of HIV transmission and Mumbai reports 41.3% involvement in professional
(Item 4). However, noteworthy misconceptions were sex work and 42.2% in begging (Gupta & Sivakami, 2016).
identified. More than half of the respondents (59.30%) Indonesia observes that 35.9% rely on sex work as their
believed that the withdrawal method performed before primary source of income, with an additional 24.4% using
ejaculation could prevent HIV transmission (Item 3), it as supplementary income, involving approximately
and a majority (71.10%) still believed that showering 60% of 209 sampled individuals in professional sex
or cleansing the genitals after intercourse could prevent work (Prabawanti et al., 2015). Notably, a study in Nepal
HIV infection (Item 5). About one-fourth (25.20%) of found that 51% of transgender individuals experienced
respondents considered deep kissing as a mechanism of discrimination in various contexts (Rana et al., 2016).
HIV transmission (Item 9). Moreover, approximately one- Using the same HIV-KQ-18 questionnaire, interviews
quarter (24.40%) believed that vaccines might prevent HIV were conducted with transgender individuals in Mandao,
infection (Item 8). Detailed results, including a breakdown Indonesia, and South Florida, the United States, where
of HIV-related knowledge according to the HIV-KQ, are over 70% demonstrated a robust understanding of HIV
provided in Table 2 and Figure 1. (Jones et al., 2020; Samsul et al., 2016). A significant
HIV-related knowledge exhibits statistical significance 80.7% of transgender individuals were aware that oral
with sexual activity in the open street (p < 0.001) and sex is a mechanism of HIV transmission. Similarly, 79.5%
the consistent usage of a barrier method (p < 0.000) of transgender individuals in the Dominican Republic
according to the Chi-square test. In addition, it suggests confirmed that oral sex contributes to HIV transmission

Volume 2 Issue 1 (2024) 4 https://doi.org/10.36922/ghes.1643