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Assessment Of Risk Factors For Hiv Infection In Female Sex Workers And Men Who Have Sex With Men In Ciudad Del Este Paraguay
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Book Synopsis Assessment of Risk Factors for HIV Infection in Female Sex Workers and Men who Have Sex with Men in Ciudad Del Este, Paraguay by : Magda Chinaglia
Download or read book Assessment of Risk Factors for HIV Infection in Female Sex Workers and Men who Have Sex with Men in Ciudad Del Este, Paraguay written by Magda Chinaglia and published by . This book was released on 2008 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis "Risk Factors for HIV Infection in Male Commercial Sex Workers by : Tida Violante
Download or read book "Risk Factors for HIV Infection in Male Commercial Sex Workers written by Tida Violante and published by . This book was released on 1995 with total page 154 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Power, Privilege and HIV Prevalence by : Cheryl Dietrich
Download or read book Power, Privilege and HIV Prevalence written by Cheryl Dietrich and published by . This book was released on 2016 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt: Objective: To understand power-related predictors for risky sexual behavior among men who have sex with men (MSM) and Transgender Women (TW) at high risk for HIV infection in Lima, Peru. Methods: Survey data from a cross-sectional sample were analyzed. Risk of unprotected anal intercourse (UAI) associated with different transactional sex roles (i.e. giving money or goods for sex, receiving, both giving and receiving) was examined separately among only those participants who engaged in transactional sex in the last 6 months and among all partnerships (transactional and non-transactional) in the last 3 months. These analyses were conducted using multivariate logistic regression and generalized estimating equations (GEE), respectively. Results: In the inter-individual analysis among individuals engaged in transactional sex, those who engaged only in giving money and/or goods for sex had an increased risk of self-reported UAI during their last act of transactional sex compared with those who received money and/or goods in exchange for sex. This effect was modified by drug and/or alcohol use during sex and all categories of the interaction of transactional sex and use of alcohol and drugs had significantly higher odds of UAI than the referent (receiving goods/money and non-use of alcohol/drugs) (ORs: 2.4-5.9). In the population level analysis, when partnerships involving giving money/goods for sex were compared to all non-transactional sex partnerships, this group demonstrated a lower risk of UAI (OR 0.36; 95% CI: 0.20, 0.66). This association remained but was non-significant (p=0.10) when the comparator was limited to non-stable, non-transactional partnerships. Conclusions: More research is needed to explore the association of risky sexual behavior among MSM and TW and different transactional sex roles. In addition, interventions should consider tailoring efforts to individuals who participate in different transactional sex roles.
Book Synopsis Risk Factors and the HIV/AIDS Situation Among Female Sex Workers' Clients in Hai Phong City, Vietnam by : Nhu To Nguyen
Download or read book Risk Factors and the HIV/AIDS Situation Among Female Sex Workers' Clients in Hai Phong City, Vietnam written by Nhu To Nguyen and published by . This book was released on 2007 with total page 354 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Prevalences, Genotypes, and Risk Factors for HIV Transmission in South America by :
Download or read book Prevalences, Genotypes, and Risk Factors for HIV Transmission in South America written by and published by . This book was released on 2005 with total page 8 pages. Available in PDF, EPUB and Kindle. Book excerpt: HIV cross-sectional studies were conducted among high-risk populations in 9 countries of South America. Enzyme-linked immunosorbent assay screening and Western blot confirmatory testing were performed, and env heteroduplex mobility assay genotyping and DNA sequencing were performed on a subset of HIV-positive subjects. HIV prevalences were highest among men who have sex with men (MSM; 2.0%-27.8%) and were found to be associated with multiple partners, noninjection drug use (non-IDU), and sexually transmitted infections (STIs). By comparison, much lower prevalences were noted among female commercial sex workers (FCSWs; 0%-6.3%) and were associated mainly with a prior IDU and STI history. Env subtype B predominated among MSM throughout the region (more than 90% of strains), whereas env subtype F predominated among FCSWs in Argentina and male commercial sex workers in Uruguay (more than 50% of strains). A renewed effort in controlling STIs, especially among MSM groups, could significantly lessen the impact of the HIV epidemic in South America.
Book Synopsis Alcohol, Tobacco, and Illicit Drug Use as Risk Factors for Onward HIV Transmission Among Men who Have Sex with Men & Transgender Women in Lima, Peru by : Katherine Vanessa Garcia-Rosales
Download or read book Alcohol, Tobacco, and Illicit Drug Use as Risk Factors for Onward HIV Transmission Among Men who Have Sex with Men & Transgender Women in Lima, Peru written by Katherine Vanessa Garcia-Rosales and published by . This book was released on 2018 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2016, there were about 70,000 (55,00–94,000) people living with HIV in Peru, with a prevalence of 16.4% among men who have sex with men (MSM) and 18.5% among transgender people.1 The aim of this study was to assess the association of heavy drinking, AUDIT score, tobacco use, and illicit drug use as independent risk factors for onward HIV transmission among MSM and transgender women in Lima, Peru. We identified 201 participants with incident HIV and used multivariate logistic regression to compare the association of each risk factor with onward HIV transmission (cluster membership assessed by phylogenetic analysis). Participants who reported heavy drinking (aOR: 1.51; 95% CI: 0.70-3.28) or had an AUDIT score ≥20 (aOR: 1.30; 95% CI: 0.47-3.65) had similar but not significantly higher odds of clustering. Current smoking status (aOR: 0.41; 95% CI: 0.10-1.73) or illicit drug use (aOR: 0.53; 95% CI: 0.19-1.49) were not associated with cluster membership. Our study findings suggest that there is a great need to focus on identifying other potential risk factors for onward HIV transmission.
Book Synopsis Gender Based Violence and HIV Risk by : Sarah Tyler Roberts
Download or read book Gender Based Violence and HIV Risk written by Sarah Tyler Roberts and published by . This book was released on 2016 with total page 122 pages. Available in PDF, EPUB and Kindle. Book excerpt: The studies within this dissertation address gender-based violence (GBV) and its relationship with risk factors for HIV acquisition in African women. Women exposed to GBV have a higher risk of HIV infection, but the mechanisms for this association are not well understood, and the mechanisms may differ according to the patterns of violence experienced. Therefore, a full assessment of pathways to HIV risk requires meaningful GBV classifications that consider variations in GBV type, frequency, and severity. This work: 1) characterizes the patterns of GBV experienced by female sex workers, 2) describes the association of those GBV patterns with mental health and sexual risk behavior, and 3) examines the relationship between GBV and adherence to pre-exposure prophylaxis (PrEP) among HIV-uninfected women in HIV serodiscordant couples. Using latent class analysis, we identified 4 GBV patterns in female sex workers, labeled Low (21% prevalence), Sexual (23%), Physical/Moderate Emotional (18%), and Severe (39%). Compared to women with Low GBV, those with Severe GBV had higher symptom scores for depression, posttraumatic stress disorder (PTSD), and alcohol abuse, and higher numbers of sex partners. Women with Sexual GBV had higher symptom scores for alcohol abuse only, but there were no differences in sexual risk behavior. Women with Physical/Moderate Emotional GBV had higher numbers of sex partners and a higher prevalence of unprotected sex, but no differences in mental health symptoms. Among women in HIV serodiscordant couples, those with recent GBV had lower PrEP adherence than women with no GBV, and the effect increased with increasing number of violent episodes. This research has contributed to HIV prevention in high-risk African women by providing a more nuanced understanding of how the relationship between GBV and on HIV risk varies by GBV type, frequency, and severity. It also provides new data on the impact of GBV on PrEP adherence, which has not been previously studied. Prevention programs for women should screen for violence and address these multiple pathways to effectively reduce HIV incidence in this vulnerable population.
Book Synopsis Prevalence of Sexually Transmitted Infections and HIV and Associated Risk Factors Among Female Sex Workers in Guangdong Providence, China by : Yan Li
Download or read book Prevalence of Sexually Transmitted Infections and HIV and Associated Risk Factors Among Female Sex Workers in Guangdong Providence, China written by Yan Li and published by . This book was released on 2008 with total page 334 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis HIV/AIDS Related Risk Profile and Corrlates of Condom Use Among Filipino Male Commercial Sex Workers by : Maridel Pasag Borja
Download or read book HIV/AIDS Related Risk Profile and Corrlates of Condom Use Among Filipino Male Commercial Sex Workers written by Maridel Pasag Borja and published by . This book was released on 1998 with total page 962 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Using the Social Ecological Model to Understand the Contextual Factors Associated with HIV Risk in Commercial Sex Workers at High Risk for Contracting HIV by :
Download or read book Using the Social Ecological Model to Understand the Contextual Factors Associated with HIV Risk in Commercial Sex Workers at High Risk for Contracting HIV written by and published by . This book was released on 2008 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: Sexually transmitted infections (STIs) and HIV infection are increasing at an alarming rate in Mexico (United Nations Program on AIDS [UNAIDS], 2006). Female sex workers (FSWs) are one of the groups affected by the increase in HIV prevalence in Mexico. Early surveillance of FSWs found seroprevalence rates of 4.8% in Tijuana and 4.9% in Ciudad Juarez, Mexico (Patterson et al., 2006b), while the most recent study of FSWs from these two cities found a seroprevalence rate of 6% (Strathdee et al, in press). Prevention efforts that are culturally sensitive and appropriately tailored are needed to stem the rise of HIV in this high-risk population. The current study examined the applicability of the Social Ecological model for HIV prevention in a sample of female sex workers (FSWs) (N=472) participating in a safe sex counseling intervention in Tijuana, Mexico. Within the framework of the Social Ecological Model we explored differential predictors of condom use by comparing women who work in bar settings to those who work on the street hypothesizing that there would be differences across venue (bar vs street) with higher condom use in bar workers. Baseline models were established using path analysis in bar (N=233); (CFI= .890, RMSEA =.062) and street workers (N=203); (CFI =.928, RMSEA = .040). For bar workers individual level factors, (self-efficacy, condom use beliefs, alcohol use before sex) and institutional level factors (condom access) were directly and indirectly related to condom use, while in street workers interpersonal level factors (social support, previous abuse, client power) and drug use were the most important factors associated with condom use. Multiple group partial structural invariance was then performed comparing street workers (N=79) to bar workers (N=103) on the 5 paths that their baseline models shared, showing that these paths were invariant across groups ([delta][chi]2(5) =6.30). Multiple group comparisons found similarities between the bar and street workers, including the relationship between self-efficacy and condom use. Baseline model comparisons found differences including the type of substance used before sex, and the relationship between monetary incentives for unprotected sex and condom use self-efficacy, supporting the need for the tailoring of interventions for women based on location of their sex work.
Book Synopsis Using the Social Ecological Model to Understand the Contextual Factors Associated with HIV Risk in Commercial Sex Workers at High Risk for Contracting HIV by : Sandra Erika Larios
Download or read book Using the Social Ecological Model to Understand the Contextual Factors Associated with HIV Risk in Commercial Sex Workers at High Risk for Contracting HIV written by Sandra Erika Larios and published by . This book was released on 2008 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt: Sexually transmitted infections (STIs) and HIV infection are increasing at an alarming rate in Mexico (United Nations Program on AIDS [UNAIDS], 2006). Female sex workers (FSWs) are one of the groups affected by the increase in HIV prevalence in Mexico. Early surveillance of FSWs found seroprevalence rates of 4.8% in Tijuana and 4.9% in Ciudad Juarez, Mexico (Patterson et al., 2006b), while the most recent study of FSWs from these two cities found a seroprevalence rate of 6% (Strathdee et al, in press). Prevention efforts that are culturally sensitive and appropriately tailored are needed to stem the rise of HIV in this high-risk population. The current study examined the applicability of the Social Ecological model for HIV prevention in a sample of female sex workers (FSWs) (N=472) participating in a safe sex counseling intervention in Tijuana, Mexico. Within the framework of the Social Ecological Model we explored differential predictors of condom use by comparing women who work in bar settings to those who work on the street hypothesizing that there would be differences across venue (bar vs street) with higher condom use in bar workers. Baseline models were established using path analysis in bar (N=233); (CFI= .890, RMSEA =.062) and street workers (N=203); (CFI =.928, RMSEA = .040). For bar workers individual level factors, (self-efficacy, condom use beliefs, alcohol use before sex) and institutional level factors (condom access) were directly and indirectly related to condom use, while in street workers interpersonal level factors (social support, previous abuse, client power) and drug use were the most important factors associated with condom use. Multiple group partial structural invariance was then performed comparing street workers (N=79) to bar workers (N=103) on the 5 paths that their baseline models shared, showing that these paths were invariant across groups ([delta][chi]2(5) =6.30). Multiple group comparisons found similarities between the bar and street workers, including the relationship between self-efficacy and condom use. Baseline model comparisons found differences including the type of substance used before sex, and the relationship between monetary incentives for unprotected sex and condom use self-efficacy, supporting the need for the tailoring of interventions for women based on location of their sex work.
Book Synopsis Evaluating Individual and Couple-level Risk Factors Associated with HIV Acquisition in HIV Serodiscordant Couples in Zambia: Alcohol Use, Fertility Desire, and HIV Acquisition from Outside Partners in an Open Cohort in Zambia by : Dvora Leah Davey
Download or read book Evaluating Individual and Couple-level Risk Factors Associated with HIV Acquisition in HIV Serodiscordant Couples in Zambia: Alcohol Use, Fertility Desire, and HIV Acquisition from Outside Partners in an Open Cohort in Zambia written by Dvora Leah Davey and published by . This book was released on 2016 with total page 93 pages. Available in PDF, EPUB and Kindle. Book excerpt: The high prevalence of serodiscordant relationships coupled with the high risk of transmission within those relationships across sub-Saharan African countries makes these couples a target for HIV prevention efforts. The development of appropriate and effective interventions for HIV prevention in serodiscordant couples must be based on accurate assessments of sexual risk behaviors, substance use, and fertility desires. My dissertation evaluates HIV acquisition and transmission in heterosexual HIV serodiscordant couples in Lusaka, Zambia. My first study analyzed the role that alcohol use plays on sexual behavior and HIV acquisition in Zambian serodiscordant couples. Men who reported heavy drinking was associated with increased odds of having =>1 outside sexual partnership (adjusted odds ratio [aOR]=2.02; 95% CI=1.58, 2.57), and condomless sex with main partner in the past 3-months (aOR=1.61; 95% CI=1.28, 2.04). Women's heavy drinking was associated with increased odds of having =>1 outside partner (aOR=1.89, 95% CI=1.35, 2.64), and condomless sex with main partner in past 3-months (aOR=1.54; 95% CI=1.31, 1.82). Women who reported being drunk daily or almost daily was associated with increased HIV acquisition (aHR=3.71; 95% CI=0.90, 15.25). Men who reported being drunk weekly or daily/almost daily was associated with increased HIV acquisition (aHR=1.72; 95% CI= 1.01, 2.93), and transmission (aHR=1.42; 95% CI=0.97, 2.10). My second study evaluated the incidence and predictors of HIV acquisition from an outside partner in serodiscordant couples in Zambia. Forty-five unlinked HIV infections occurred among women (1.85 per 100-couple-years [CY]) and 55 unlinked HIV infections occurred among men (1.82 per 100 CY). Risk of female unlinked infection was associated with baseline female alcohol consumption (aHR=5.44; 95% CI: 1.03, 28.73), recent genital ulcers and/or genital inflammation (aHR=6.09; 95% CI: 2.72, 13.64 and aHR=11.92; 95% CI: 5.60, 25.37, respectively). Risk of male unlinked HIV infection was associated with reporting being drunk weekly or daily/almost daily at baseline (aHR=3.52; 95% CI=1.19, 10.46), recent genital inflammation (aHR=8.52; 95% CI: 3.82, 19.03), genital ulceration (aHR=4.27; 95% CI: 2.05, 8.89), self-reporting =>1 outside partner (aHR=3.36; 95% CI: 1.53, 7.37). My third study evaluated the effect of fertility desires on HIV acquisition among HIV serodiscordant couples in Zambia. Among a sub-set of 1,029 serodiscordant couples, 311 agreed that they wanted a child in the future (30.4%), and 368 agreed they did not want a child or did not know (36.0%), and 344 couples disagreed about having a child (33.6%), of which in 212 couples (61.6% of disagreeing couples) the man wanted a child but the woman did not, and in 132 couples (38.3% of disagreeing couples) the woman wanted a child but the man did not. The adjusted risk ratio for woman's HIV acquisition was 2.06 (95% CI=1.40, 3.03) among women who wanted a child, 1.75 (95% CI=1.07, 2.87) for men who wanted a child in the next 12-months, and 2.55 (95% CI=1.32, 4.93) among couples who agreed that they wanted a child compared to couples who agreed they did not want a child. In conclusion, heavy alcohol use plays an important role in linked and unlinked HIV acquisition and transmission in serodiscordant couples. The strongest predictors of unlinked infection in serodiscordant relationships were alcohol use, genital inflammation and ulceration prior to infection. Further, women were particularly vulnerable when they or their partner wanted to have a child. These findings will help improve the implementation of HIV prevention and safer conception services among heterosexual serodiscordant couples in Southern Africa and beyond.
Book Synopsis Substance Use, Sexual Networks, and HIV Risk Among Men who Have Sex with Men and Transgender Women in Peru by : Angela K. Ulrich
Download or read book Substance Use, Sexual Networks, and HIV Risk Among Men who Have Sex with Men and Transgender Women in Peru written by Angela K. Ulrich and published by . This book was released on 2017 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: In Peru, the HIV epidemic is concentrated among men who have sex with men (MSM) and transgender women (TGW) in whom HIV incidence rates are as high as 4.2 per 100 person-years with HIV prevalence reported to be as high as 22% in MSM and up to 30% in TGW. This dissertation seeks to add to the knowledge of the structure of sexual networks, namely the level and predictors of sexual concurrency among MSM and TGW in Peru (Aim 1), and the understanding of risk factors for HIV acquisition in MSM and TGW with high levels of substance use in Lima (Aim 2). Methods: Data are from the 2011 Peruvian Biobehavioral Surveillance survey (Aim 1) and the Sabes cohort study conducted in Lima from 2013-2016 (Aim 2). Data were collected with the computer assisted self-interview (CASI) (Aim 1 & 2); HIV testing was performed with Determine 1/2 rapid antibody tests (Aim 1 & 2), pooled nucleic acid amplification test (NAAT), and Western Blot to determine Fiebig Stage at HIV diagnosis. Statistical methods used include Poisson regression and generalized estimating equations (GEE) (Aim 1), and Pearson's Chi-square, Poisson regression estimated with GEE, and stratified Cox proportional hazards survival analysis with time-varying covariates (Aim 2). Results: Concurrency is a common practice among MSM and TGW in Peru with a 3-month cumulative prevalence of over 23%. There was evidence of negotiated safety--those with a stable partner were less likely to have condomless anal intercourse (CLAI) with a concurrent non-stable partner. In the Sabes cohort, HIV incidence was 11.7 per 100 person-years of follow-up. Those with alcohol use disorders (AUD) were significantly more likely to attend a venue that served alcohol, binge drink, and use marijuana or amyl nitrites. AUD modified the association between the time-varying behavioral factors and HIV; behavioral risk factors (binge drinking, marijuana use, sex with a casual partner, client, or one-time partner) were most strongly associated with HIV acquisition amongst those with dependent drinking patterns. Conclusion: This study suggests that AUD is linked to HIV risk in two important ways: first, through CLAI with non-stable partners and second, through amplifying the impact of other HIV risk behaviors. These studies suggest that harm reduction approaches, such as negotiated safety with concurrent partners, and treatment of AUDs to decrease alcohol intake could decrease the HIV risk associated with these behaviors.
Book Synopsis Prevention of HIV/AIDS Among Young People in Bangladesh by :
Download or read book Prevention of HIV/AIDS Among Young People in Bangladesh written by and published by . This book was released on 2007 with total page 70 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Public Health Reports written by and published by . This book was released on 2010 with total page 928 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Role of Individual Or Neighborhood Factors by : Henry Fisher Raymond
Download or read book The Role of Individual Or Neighborhood Factors written by Henry Fisher Raymond and published by . This book was released on 2011 with total page 122 pages. Available in PDF, EPUB and Kindle. Book excerpt: The majority of new HIV infections occur among high-risk groups such as men who have sex with men (MSM) and transfemales. Segments of these populations are also more likely to be economically disadvantaged. Economic disadvantage or low socioeconomic status has been linked to disease acquisition, morbidities and mortality. Interventions have been proposed to address these health issues through the reduction of poverty. However, this approach to intervention does not address underlying structural factors such as high HIV prevalence in impoverished neighborhoods and thus in social and sexual networks. The present analysis examines low individual socioeconomic status and /or social and sexual network factors and their relationship to HIV acquisition risk among three populations at high-risk for HIV infection. Geographic analysis examined residential patterns and neighborhood patterns of HIV prevalence in San Francisco. Data collected in San Francisco from White MSM, Black MSM and transfemales were analyzed using Poisson regression to determine the factors associated with engaging in more episodes of potentially serodiscordant unprotected receptive anal intercourse. As expected, transfemales and Black MSM were more likely to live in areas of higher HIV prevalence and lower income compared to White MSM. Interestingly the areas of higher HIV prevalence and lower income were also the areas with greater numbers of HIV prevention and care services. Black MSM and transfemales had lower socioeconomic status (SES) scores compared to White MSM. Black MSM were more likely to report serodiscordant partnerships and higher numbers of potentially serodiscordant unprotected sex acts. Decreasing SES and increasing neighborhood HIV/AIDS case density did not predict serodiscordant partnerships in any group. Increasing neighborhood HIV prevalence predicted an increase in the number of potentially serodiscordant unprotected sex acts among transfemales and Black MSM but only significantly so for transfemales. HIV prevention interventions must also consider neighborhood factors such as neighborhood HIV prevalence in addition to considering individual level behavior change.
Book Synopsis HIV Prevalence And Sexual Behavior Among Trans Women In Paraguay, 2017 by :
Download or read book HIV Prevalence And Sexual Behavior Among Trans Women In Paraguay, 2017 written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: HIV Prevalence and Sexual Behavior among Trans Women in Paraguay, 2017Aguilar Gloria1,2, Mc Farland Willi3, Kawabata Anibal1, Samudio Tania1, Lopez Gladys1, Estigarribia Gladys2.National HIV program1, University of Caaguazu2, Global Health Sciences, University of California San Francisco3Background: Trans women may be the population most vulnerable to HIV in the world, with prevalence in Latin America ranging from 18-38%. In Paraguay too, HIV prevalence (26%) was higher among trans women than among men who have sex with men (MSM) and female sex workers (FSW) when first measured in 2014. We therefore conducted a bio-behavioral survey among trans women in Paraguay in 2017, incorporating novel methods in the design to increase inclusion,Methods:We conducted a cross-sectional survey-To maximize efficiency in reaching diverse trans women, we used a hybrid method (u201cStarfish Samplingu201d) that combines venue recruitment, a random sample of clients, and short-chain peer referral. The study began with mapping places of sex work and where trans women congregate. A random selection of trans women clients was also conducted. Further, trans women referred peers to the study. Participants complete a questionnaire on demographic characteristics and behavior, and blood samples were drawn for HIV antibody testing. Participants provided written informed consent. Results: A total of 304 trans women were enrolled. Participants were young, with 55.9% in their 20s. The majority had secondary education or less (74.5%). HIV prevalence was 25.6% (95% confidence interval 19.3-31.9%). Trans women reported a mean of 22.5 casual partners in the last 6 months, with whom condom use was 73.0%.The proportion of trans women who had sex for the first time under age 14 years was 58.6%. The majority of trans women (82.6%) reported selling sex. Conclusios: Our bio-behavioral survey found the prevalence of HIV consistently high among trans women in Paraguay, confirming this population remains the most severely affected. The young age of the population, the young age of sexual debut, the high partner number, and inconsistent condom use point to high potential for continuing transmission. New strategies are necessary to improve education on reducing acquisition risk among transgender women.
