Gender Abuse, Depressive Symptoms, and HIV and Other Sexually Transmitted Infections Among Male-to-Female Transgender Persons: A Three-Year Prospective Study
Gender Abuse, Depressive Symptoms, and HIV and Other Sexually Transmitted Infections Among Male-to-Female Transgender Persons: A Three-Year Prospective Study
复制标题
DOI：
10.2105/ajph.2011.300568
复制
发表时间：
2013-02-01
影响因子：
12.7
通讯作者：
Becker, Jeffrey
中科院分区：
文献类型：
--
作者：
Nuttbrock, Larry;Bockting, Walter;Becker, Jeffrey
目标.我们研究了性别虐待和抑郁症状作为男性到女性的跨性别者（MTF）中艾滋病毒和其他性传播感染（HIV/STI）的危险因素。我们对来自纽约大都会区的230名MTF进行了一项为期3年的前瞻性研究，研究与HIV、梅毒、B型肝炎、衣原体和淋病事件相关的因素。统计学方法包括考克斯比例风险分析与时间变化的协变量。在较年轻的MTF（19-30岁）中，性别虐待可预测抑郁症状（流行病学研究中心抑郁评分>= 20），性别虐待与抑郁症状相结合可预测高危性行为（无保护的接受性肛交）和HIV/STI事件。这些关联独立于社会经济地位、种族、性取向、激素治疗和变性手术。性别虐待是较年轻的产妇中艾滋病毒/性传播感染的一个基本的远距离风险因素。需要对年轻的MTF进行干预，以减少性别虐待的心理影响，并限制这种虐待对高风险性行为的影响。性别虐待对艾滋病毒/性传播感染的影响存在年龄差异，这表明同龄人干预措施的效力，即年长的MTFs教年轻的MTFs如何科普这种虐待。(Am J公共卫生。2013; 103：300-307. doi：10.2105/AJPH.2011.300568）
Objectives. We examined gender abuse and depressive symptoms as risk factors for HIV and other sexually transmitted infections (HIV/STI) among male-to-female transgender persons (MTFs).Methods. We conducted a 3-year prospective study of factors associated with incident HIV, syphilis, hepatitis B, chlamydia, and gonorrhea among 230 MTFs from the New York Metropolitan Area. Statistical techniques included Cox proportional hazards analysis with time varying covariates.Results. Among younger MTFs (aged 19-30 years), gender abuse predicted depressive symptoms (Center for Epidemiologic Studies Depression score >= 20), and gender abuse combined with depressive symptoms predicted both high-risk sexual behavior (unprotected receptive anal intercourse) and incident HIV/STI. These associations were independent of socioeconomic status, ethnicity, sexual orientation, hormone therapy, and sexual reassignment surgery.Conclusions. Gender abuse is a fundamental distal risk factor for HIV/STI among younger MTFs. Interventions for younger MTFs are needed to reduce the psychological impact of gender abuse and limit the effects of this abuse on high-risk sexual behavior. Age differences in the impact of gender abuse on HIV/STI suggest the efficacy of peer-based interventions in which older MTFs teach their younger counterparts how to cope with this abuse. (Am J Public Health. 2013; 103:300-307. doi:10.2105/AJPH.2011.300568)