Many transgender ladies with HIV should not examined for STIs, in response to evaluation

February 25, 2021

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Despite national guidelines recommending that sexually active people with HIV be tested for sexually transmitted diseases annually, many transgender women with HIV are not tested for syphilis, chlamydia, or gonorrhea, researchers reported.

Writing in clinical infectious diseases, Katy Town, PhD, An epidemiologist in the CDC’s STD Prevention Unit and colleagues said that most transgender women with HIV are in care, but “Clinicians may not have appropriate sexual behavior histories in a way that allows patients to feel safe and feeling comfortable to discuss their sexual practices, which may indicate the need for STI testing. “

“A sexual history should be included as a standard aspect of clinical care to ensure that all people at risk for STDs receive adequate care, including screening for syphilis, chlamydia and gonorrhea,” said Town said Healio.

“It is important for clinicians to create appropriate sexual behavior histories so that all patients are safe and comfortable to discuss their sexual practices,” Town continued. “To improve the delivery and use of these services, clinicians can benefit from education and training on cultural competencies related to the appropriate care and clinical management of transgender patients.”

Town and colleagues used data from the Medical Monitoring Project, a CDC-supported HIV monitoring system, to examine the rate of STI testing in 217 transgender women with HIV.

The results showed that only 47.7% (95% CI, 39.4% -56.1%) of transgender women in the past year developed chlamydia and 46.5% (95% CI, 38.2% -54 , 8%) were tested for gonorrhea. Additionally, only 64.7% (95% CI, 56.8% -72.6%) were tested for syphilis, and only 42.8% (95% CI, 34.8% -51.1) in the last 12 months %) of participants were tested for all three STIs.

The study’s main limitations were the inability to investigate STI diagnoses and the lack of STI screening data from providers outside of each patient’s normal source of care, Town said. She noted that the existing literature on STI exposure and screening in transgender women is “sparse” and that the limitations of this study are in line with the few other articles available on the subject.

Still, Town said the low test rates were “worrying”.

“There is an opportunity to increase STI testing in transgender HIV women by having STI testing as part of routine HIV treatment visits,” she said.

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