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The high prevalence of HIV and syphilis found among female transgender sex workers (FTSWs) in Argentina calls for the study of factors leading to negative health consequences. Given the particular characteristics observed in this population (high marginalization, school dropout, and low adherence to healthcare services), we explored the association of several socio-demographic characteristics with syphilis and HIV infections, and the determinants of condom use. This study revealed that FTSWs from Argentina were exposed to several risk factors decreasing thus their ability to negotiate condom use and leading to increased risk for transmission of HIV and other sexually transmitted infections (STIs). Strategies to reduce HIV and syphilis in this population should consider interventions aimed at decreasing violence and substance use which appear to be the most important determinants. Results of this study will contribute to the global information among FTSWs.

Objective: Estimate the prevalence of human immunodeficiency virus (HIV) infection and Treponema pallidum in Argentine female sex workers (FSW), and describe the sociodemographic characteristics of this population group associated with HIV transmission., Methods: A cross-sectional study and convenience sampling were conducted in FSW over 18 years of age in nine Argentine cities from October 2006 to December 2009. A total of 1 255 women participated in this study. A group of FSW was especially trained to invite other women to participate in the workshops and undergo screening for HIV and T. pallidum., Results: The most noteworthy socioepidemiological characteristics of the FSW included a high percentage of sexual abuse, limited condom use with noncommercial sex partners, and a high percentage of violence. HIV prevalence was 2% (25/1 255, 95% confidence interval [95% CI]:1.2-2.8) and T. pallidum prevalence was 22.4% (245/1 094; 95% CI: 19.9-24.9). In the city of La Plata, HIV prevalence in FSW was significantly lower compared to that of other regions of the country (0.3% vs. 2.7%, P < 0.05, respectively)., Conclusions: The lower HIV prevalence and the higher rate of condom use reported by the women from La Plata surveyed suggest that the presence of a health center for FSW has a direct influence on reducing risky behavior and, consequently, HIV infection. The creation of "friendly" health centers like the one already in this city contributes to providing a comprehensive response to the problems faced by these women and encourages use of the health system. It therefore helps reverse their vulnerability and higher risk of contracting HIV and other sexually transmitted infections.

In a previous cohort study among 327 men who have sex with men (MSM) in Buenos Aires, an HIV incidence rate of 3.9 per 100 persons-year was reported. Using data from this study, we determined: (a) HIV/STI co-infections; (b) clinical manifestations of incident HIV infections; (c) syphilis incidence and its associated risk factors; and (d) adherence and immune response to hepatitis B virus (HBV) vaccine. During the cohort study, 12 incident HIV infections were found. Within this group, HIV infection alone was most frequent (42%), followed by co-infection of HIV/HBV (33%), and triple co-infection of HIV/HBV/syphilis (25%). The most frequent clinical manifestations among incident HIV cases were: pharyngitis, fever, lymphadenopathy, asthenia, and myalgia. Seven new syphilis infections were detected yielding an incidence rate of 2.4 (95% CI=1.07 - 4.73) per 100 persons-year. Sex work was the only significant risk factor associated with syphilis seroconversion (hazard rate=10.93, p-value=0.033). Only 7% of cohort participants reported having received HBV vaccine. Ninety-percent of the 204 cohort members who agreed to be vaccinated completed the HBV vaccination schedule with an immune response rate of 85%. Our findings suggest the need to increase the access to serologic testing for STI and HBV immunization, as well as the developing of effective HIV/STI behavioral and educational prevention programs among MSM in Buenos Aires. [ABSTRACT FROM AUTHOR]

Summary: Objectives: Due to the scarce data on the prevalence of sexually transmitted infections (STIs) among male-to-female trans-sex workers (TSW) and male sex workers (MSW) in Argentina, the present study aimed to estimate the incidence of human immunodeficiency virus (HIV), and the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum. Human papillomavirus (HPV) and Chlamydia trachomatis infections were tested among TSW. Methods: Two hundred and seventy-three TSW and 114 MSW were recruited by nongovernmental organizations. HIV incidence was estimated by STARHS (serologic testing algorithm for recent HIV seroconversion). HPV and C. trachomatis infections were tested in anal cells from TSW. Results: TSW showed significantly higher prevalences of HIV (34.1 vs. 11.4%), HBV (40.2 vs. 22.0%), and T. pallidum (50.4 vs. 20.4%) than MSW. TSW tested positive for HPV in 111/114 cases and for C. trachomatis in 4/80 cases. Investigation of HBV, HCV, HIV, and T. pallidum co-infections showed that 72% of TSW and 39% of MSW had at least one STI. T. pallidum was the most frequent mono-infection. The estimated HIV incidence was 10.7 per 100 person-years (95% confidence interval (CI) 3.8–17.7) for TSW and 2.3 per 100 person-years (95% CI 0–6.7) for MSW. Conclusions: The high prevalence of STIs and the high incidence of HIV demonstrate the great vulnerability of these high-risk populations and indicate the urgent need for preventive strategies on intervention and facilitation of access to healthcare programs. [ABSTRACT FROM AUTHOR]