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Introduction: HIV prevalence and sexual risk have been estimated very high for transgender people. However, the limited sampling and data collection methods used in current research on transgender people potentially led to overrepresentation and generalisation of people at risk for HIV. Current HIV prevalence estimates in transgender populations are generalised from studies mainly focusing on transgender women engaging in sex work. Moreover, studies focusing on non-binary people, who identify with a broad range of identities beyond the traditional male and female gender identities, are scarce. Objectives: To estimate the HIV prevalence rate in the Flemish and Brussels (Belgium) transgender population, including transgender women, transgender men and non-binary people, and to identify the associated risk factors. Methods: In this community-based cross-sectional study, self-identified transgender and non-binary (TGNB) people will be recruited through a two-stage time-location sampling approach. First, community settings in which TGNB people gather will be mapped to develop an accurate sampling frame. Secondly, a multistage sampling design is applied involving a stratification based on setting type (healthcare facilities vs outreach events), a selection of clusters by systematic sampling and a simple random selection of TGNB people within each cluster. Participants will complete an electronic self-reported survey to measure sociological, sexual and drug-using behaviors (risk factors) and oral fluid aliquots will be collected and tested for HIV antibodies. Logistic regression models will be used to evaluate risk factors independently associated with HIV infection. The presented study is registered at ClinicalTrials.gov (NCT04930614). Discussion: This study will be the first to investigate the HIV prevalence rates and associated risk behaviors in an accurate representation of the TGNB population in a Western European country. The findings will globally serve as a knowledge base for identifying subgroups at risk for becoming infected with HIV within TGNB people and to set up targeted prevention programs. [ABSTRACT FROM AUTHOR]

Background: Transfusion‐transmissible infections such as hepatitis B virus (HBV) remain a major concern for the safety of blood transfusion. This cross‐sectional study aimed to assess the trend of HBV prevalence and associated risk factors among a first‐time donor population in a low endemic country. Study Design and Methods: Between 2010 and 2018, blood samples were collected from first‐time donors presented at donor collection sites of Belgian Red Cross‐Flanders. They were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibodies (anti‐HBc), and HBV DNA, HIV and hepatitis virus C (HCV) antibodies and RNA, and syphilis antibodies. Results: A total of 211,331 first‐time blood donors (43.7% males, median age 25 years) were analyzed. HBsAg prevalence decreased from 0.06% in 2010 to 0.05% in 2018 (p =.004) and this declining trend was accompanied by an increased number of donors in the HBV vaccinated birth cohort (p <.001). HBsAg prevalence was 0.33% in foreign‐born donors and 0.02% in Belgian natives (p <.001). Multivariate risk profiling showed that anti‐HBc positivity was significantly associated with mainly foreign‐born donors (odds ratio [OR] = 9.24) but also with older age (OR = 1.06), male gender (OR = 1.32), year of blood donation (OR = 0.94), and co‐infections with HCV (OR = 4.31) or syphilis (OR = 4.91). Discussion: The decreasing trend in HBV prevalence could mainly be explained by the introduction of the universal HBV vaccination. Being born in endemic areas was the most important predictor for HBV infection while the co‐infections with syphilis suggest unreported sexual risk contacts. [ABSTRACT FROM AUTHOR]