Eleven seeds recruited partners and formed clusters ranging in size from four to 250 people. However, as Dr Long commented, “The partners of transgender women do not form a social network.” Her team therefore asked transgender female “seeds” to recruit their sexual partners into the study, who were then asked to recruit their sexual partners. This involves engaging ‘seeds’ who are volunteers who then recruit their social contacts to the study. Participants were recruited through respondent-driven sampling. There was a minority of men who have sex with men among the trans women’s sexual partners, but they had different characteristics from their other partners. The study from Lima also found that the partners of transgender women form a distinct group, in general, from gay and bisexual men. It also found that a lot of transgender women were in clusters with each other, suggesting that trans women’s high HIV rates may partly be due to their belonging to a small, relatively isolated, and tightly networked community. It suggested that the sexual partners of transgender women form a separate and distinct risk group. Opportunistic infections common in people with advanced HIV disease include Pneumocystis jiroveci pneumonia Kaposi sarcoma cryptosporidiosis histoplasmosis other parasitic, viral, and fungal infections and some types of cancer. It found that 47% of transgender women were in a ‘cluster’ or linked group of infections along with at least one heterosexual man (ruling out men who injected drugs) but only 16% in a cluster with a gay or bisexual men.Īn infection that occurs more frequently or is more severe in people with weakened immune systems, such as people with low CD4 counts, than in people with healthy immune systems. It used phylogenetic analysis to retrospectively re-classify the male partners of trans women as heterosexual, unless their HIV was also linked genetically to other men via sexual contact. However, a study from San Francisco presented at the 2017 IAS conference in Paris challenged this view. Figures like this have led epidemiologists to conclude that transgender women must be getting their HIV from men who have sex with other men.
Yet prevalence in the heterosexual male population is less than 0.4%. HIV prevalence in gay men is currently about 12-18% but prevalence in transgender women is 30%. Transgender women worldwide generally have rates of HIV even higher than gay and bisexual men, and Peru is no exception. The study was presented at the recent Conference on Retroviruses and Opportunistic Infections (CROI 2019) by Dr Jessica Long of the University of Washington in Seattle. A study from Peru’s capital, Lima, has found that the sexual partners of transgender women there are largely heterosexual, cisgender men who rarely have sex with other men.