HIV and syphilis prevalence among transgender women and men who have sex with men, Silom Community Clinic, Bangkok, Thailand, 2017–2019

ABSTRACT

We assessed HIV and syphilis infection among MSM and TGW attending Silom Community Clinic from 2017 to 2019. Walk-in and referral clients completed a registration application including a question on gender identity. We compared the prevalence of HIV, syphilis, and HIV and syphilis coinfection among TGW and MSM. In a total of 1050 clients, 276 (26.3%) were TGW and 774 (74.7%) were MSM. Among TGW clients, HIV prevalence was 29.8%, syphilis prevalence was 38.4%, and coinfection prevalence was 18.5%. Comparing prevalence among TGW to MSM, the adjusted prevalence ratio (aPR) for HIV was 1.8 (95% CI:1.4–2.3), for syphilis was 1.2 (95% CI:1.0–1.4), and for HIV and syphilis coinfection was 2.1 (95% CI:1.4–2.9). The prevalence of syphilis was higher than HIV among TGW, with a PR of 1.3 (95% CI:1.1–1.6), and among MSM, with a PR of 1.4 (95% CI:1.2–1.7). TGW age 15–21 years had an HIV prevalence of 16.9% and syphilis prevalence of 30.8%. After adjusting for age, referral, and sexual behaviors, TGW remain significantly associated with HIV and syphilis prevalence. There is a substantial burden of HIV and HIV/syphilis co-infection among TGW. HIV/STI prevention are needed for TGW, including linkage to HIV care.

Acknowledgements

We would like to acknowledge the support of personnel from the CDC’s Management Information Systems Office (MISO): Mr. Edward Martin, Ms. Pattabhi Nunna, Ms. Patricia Obermaier, Mr. Joshua Williams and Mr. Ned Humphreys. We would also like to thank Ms. Kanokpan Pancharoen, Mr. Wipas Wimonsate, and Dr. Michael C. Thigpen for their support of the piloting and use of the SC2Touch registration application. We would like to acknowledge the clients of SCC, and staff at the SCC who support HIV counseling and testing. We dedicate this work to the memory of Supaporn Chaikummao, and Patrick J. Flaherty who devoted their professional lives to the care of persons at risk of HIV infection. All authors and co-authors participated in the conduct of the study and contributed to the manuscript. Eileen F. Dunne contributed to the conception and design, analysis, generation, critical review of the manuscript and interpretation of the findings; Frits van Griensven contributed to the conception and design, and critical review of the manuscript; Philip A. Mock contributed to design, acquisition of data, manuscript writing, critical review of the manuscript, and conducted the main statistical analysis of the data; Sarika Pattanasin supported statistical analysis, manuscript writing and interpretation of the findings; Suzi Connor contributed to the acquisition of data and critically reviewed the manuscript. Wichuda Sukwicha contributed to the acquisition of data. Siobhan O’Connor contributed to critical review of the manuscript and interpretation of the findings; Joseph Woodring contributed to development of the manuscript and critical review; Andrew C. Hickey, Chidanan Krasan, Oranuch Kongpechsatit, Anupong Chitwarakorn, Chaiwat Ungsedhapand contributed to the acquisition of data and the critical review of the findings. All authors agree to be accountable for all aspects of the work and approved the text.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Disclaimer

The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

Additional information

Funding

This work was supported by the Division of HIV/AIDS Prevention, National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention, Centers for Disease Control and Prevention.