Skip to main content

Advertisement

SpringerLink
Log in

HIV Prevalence, Risk Behavior, Hormone Use and Surgical History Among Transgender Persons in Thailand

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

While Male-to-female transgender persons (TG) are believed to often engage in sex work and have high HIV infection risk, little is known about demographics, surgical and hormone use history, risk behaviors and HIV prevalence. Between March and October 2005, 474 TG from Bangkok, Chiangmai, and Phuket were surveyed using venue-day-time sampling. Of 474 participants, overall HIV prevalence was 13.5%. Most participants had completed at least secondary or vocational education (79.2%), gender self-identified as female (89.0%), had received money, gifts or valuables for sex (60.8%), and reported hormone use (88.6%). Surgical history was taken from 325 participants. Of these, 68.6% reported some form of surgery and 11.1% had undergone penile-vaginal reconstructive surgery. In multivariate analysis, being recruited from a park/street; older age, anal sex role identification as “versatile” and anal sex debut before age 13 were independently associated with HIV prevalence. The development, implementation and evaluation of culturally appropriate sexual health interventions for Thai TG is urgently needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gay & Lesbian Alliance against Defamation. Transgender glossary of terms. Available at: http://www.glaad.org/reference/transgender. Accessed 15 November 2010.

  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Text Revision (DSM-IV-TR) ed. Washington, DC: American Psychiatric Association; 2000.

  3. Meyerowitz J. How sex changed: a history of transsexuality in the United States. Cambridge, MA and London, England: Harvard University Press; 2002.

    Google Scholar 

  4. Riggle EDB, Tadlock BL, editors. Gays and lesbians in the democratic process: public policy, public opinion, and political representation. New York, NY: Columbia University Press; 1999.

    Google Scholar 

  5. Lombardi EL, Wilchins RA, Priesing D, Malouf D. Gender violence: Transgender experiences with violence and discrimination. J Homosex. 2001;42:89–101.

    Article  PubMed  CAS  Google Scholar 

  6. Kenagy GP. Transgender health: Findings from two needs assessment studies in Philadelphia. Health Soc Work. 2005;30:19–26.

    PubMed  Google Scholar 

  7. Dean L, Meyer IH, Robinson K, et al. Lesbian, gay, bisexual, and transgender health: Findings and concerns. J Gay Lesbian Med Assoc. 2000;4:101–51.

    Article  Google Scholar 

  8. Clements-Nolle K, Marx R, Katz M. Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. J Homosex. 2006;51:53–69.

    Article  PubMed  Google Scholar 

  9. Gay and Lesbian Medical Association and LGBT health experts. Healthy People 2010 Companion Document for Lesbian, Gay, Bisexual, and Transgender (LGBT) Health. San Francisco, CA: Gay and Lesbian Medical Association; 2001.

    Google Scholar 

  10. Wiessing LG, van Roosmalen MS, Koedijk P, Bieleman B, Houweling H. Silicones, hormones and HIV in transgender street prostitutes. AIDS. 1999;13:2315–6.

    Article  PubMed  CAS  Google Scholar 

  11. van Kesteren PJ, Asscheman H, Megens JA, Gooren LJ. Mortality and morbidity in transsexual subjects treated with cross-sex hormones. Clin Endocrinol (Oxf). 1997;47:337–42.

    Article  Google Scholar 

  12. Hage JJ, Kanhai RC, Oen AL, van Diest PJ, Karim RB. The devastating outcome of massive subcutaneous injection of highly viscous fluids in male-to-female transsexuals. Plast Reconstr Surg. 2001;107:734–41.

    Article  PubMed  CAS  Google Scholar 

  13. Clements-Nolle K, Marx R, Guzman R, Katz M. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: Implications for public health intervention. Am J Public Health. 2001;91:915–21.

    Article  PubMed  CAS  Google Scholar 

  14. Garofalo R, Deleon J, Osmer E, Doll M, Harper GW. Overlooked, misunderstood and at-risk: Exploring the lives and HIV risk of ethnic minority male-to-female transgender youth. J Adolesc Health. 2006;38:230–6.

    Article  PubMed  Google Scholar 

  15. Herbst JH, Jacobs ED, Finlayson TJ, et al. Estimating HIV Prevalence and Risk Behaviors of Transgender Persons in the United States: A Systematic Review. AIDS Behav. 2008;12:1–17.

    Article  PubMed  Google Scholar 

  16. Simon PA, Reback CJ, Bemis CC. HIV prevalence and incidence among male-to-female transsexuals receiving HIV prevention services in Los Angeles County. AIDS. 2000;14:2953–5.

    Article  PubMed  CAS  Google Scholar 

  17. Kellogg TA, Clements-Nolle K, Dilley J, Katz MH, McFarland W. Incidence of human immunodeficiency virus among male-to-female transgendered persons in San Francisco. J Acquir Immune Defic Syndr. 2001;28:380–4.

    PubMed  CAS  Google Scholar 

  18. Nemoto T, Operario D, Keatley J, Han L, Soma T. HIV risk behaviors among male-to-female transgender persons of color in San Francisco. Am J Public Health. 2004;94:1193–9.

    Article  PubMed  Google Scholar 

  19. Pisani E, Girault P, Gultom M, et al. HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia. Sex Transm Infect. 2004;80:536–40.

    Article  PubMed  CAS  Google Scholar 

  20. Population Services International. Tracking survey: Transgenders in Pattaya. Social Marketing Research Series: the PSI dashboard. Washington, D.C.: Population Services International; 2005.

    Google Scholar 

  21. Jackson PA, Sullivan G, editors. Lady boys, tom boys, rent boys: male and female homosexualities in contemporary Thailand. Chiangmai, Thailand: Silkworm Books; 2000.

    Google Scholar 

  22. Beyrer C. War in the blood: sex, politics and AIDS in Southeast Asia. London, New York and Bangkok: Zed Books and White Lotus; 1998.

    Google Scholar 

  23. Pramoj Na Ayutthaya P. Katoey identity taking in cabaret show [Master Thesis]. Chiangmai, Thailand: Chiangmai University; 2003. (in Thai).

  24. Sa-Nguankeaw S. Process of development and maintaining katoey identity in Muslim society [Master Thesis]. Bangkok, Thailand: Thammasart University; 2003. (in Thai).

  25. Centers for Disease Control and Prevention (CDC). HIV prevalence among populations of men who have sex with men–Thailand, 2003 and 2005. MMWR Morb Mortal Wkly Rep. 2006;55:844–8.

    Google Scholar 

  26. MacKellar D, Vallerot L, Karon J, Lemp G, Janssen R. The young men’s survey: Methods for estimating HIV seroprevalence and risk factors among young men who have sex with men. Public Health Rep. 1996;3:138–44.

    Google Scholar 

  27. Mansergh G, Naorat S, Jommaroeng R, et al. Adaptation of venue-day-time sampling in Southeast Asia to access men who have sex with men for HIV assessment in Bangkok. Field Methods. 2006;18:135–52.

    Article  Google Scholar 

  28. Liang KY, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13–22.

    Article  Google Scholar 

  29. Guadamuz TE, Wimonsate W, Varangrat A, et al. Correlates of forced sex among populations of men who have sex with men in Thailand. Arch Sex Behav. 2009 Oct 15. [Epub ahead of print].

  30. Choi KH, Liu H, Guo Y, Han L, Mandel JS, Rutherford GW. Emerging HIV-1 epidemic in China in men who have sex with men. Lancet. 2003;361:2125–6.

    Article  PubMed  Google Scholar 

  31. Girault P, Saidel T, Song N, et al. HIV, STIs, and sexual behaviors among men who have sex with men in Phnom Penh, Cambodia. AIDS Educ Prev. 2004;16:31–44.

    Article  PubMed  Google Scholar 

  32. Poundstone KE, Strathdee SA, Celentano DD. The social epidemiology of human immunodeficiency virus/acquired immunodeficiency syndrome. Epidemiol Rev. 2004;26:22–35.

    Article  PubMed  CAS  Google Scholar 

  33. Jackson PA. Tolerant but unaccepting: the myth of a Thai “gay paradise”. In: Jackson PA, Cook NM, editors. Genders & sexualities in Modern Thailand. Chiangmai, Thailand: Silkworm Books; 1999. p. 227–42.

    Google Scholar 

Download references

Acknowledgments

The authors are grateful to the participants in the assessment. We would like to thank the following individuals for contributing to this assessment: S. Naorat, P. Akarasewi, C. Kittinunvorakoon, P. Wasinrapee, S. Kurachit, B. Jumtee, N. Tippanont, T. Chemnasiri, and W. Thienkrua of the Thailand Ministry of Public Health—U.S. Centers for Disease Control and Prevention Collaboration; S. Thanprasertsuk and P. Sirivongrangson of the Dept of Disease Control, Thailand Ministry of Public Health, Nonthaburi; S. Tantipaibulvut, A. Jamrasrak and P. Chuariyakul of the AIDS Research Centre, Thai Red Cross Society; and K. Kanggarnrua, D. Linjongrat and P. Chanlearn of the Rainbow Sky Association of Thailand, Bangkok, Thailand. The assessment was supported by the Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention. This paper was completed as part of TE Guadamuz’s dissertation in the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health. TE Guadamuz was supported by the Ruth L. Kirschstein National Research Service Award (F31 AI064144) from the U.S. National Institute of Allergy and Infectious Diseases. The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

  1. Thailand Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Ministry of Public Health, DDC 7 Building, 11000, Nonthaburi, Thailand

    Thomas E. Guadamuz, Wipas Wimonsate, Anchalee Varangrat, Janet M. McNicholl, Philip A. Mock, Jordan W. Tappero & Frits van Griensven

  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Thomas E. Guadamuz

  3. AIDS Research Center, Thai Red Cross Society, Bangkok, Thailand

    Praphan Phanuphak & Rapeepun Jommaroeng

  4. Rainbow Sky Association of Thailand, Bangkok, Thailand

    Rapeepun Jommaroeng

  5. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Janet M. McNicholl & Frits van Griensven

  6. Global AIDS Program, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Jordan W. Tappero

Authors
  1. Thomas E. Guadamuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wipas Wimonsate
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anchalee Varangrat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Praphan Phanuphak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rapeepun Jommaroeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Janet M. McNicholl
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Philip A. Mock
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jordan W. Tappero
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Frits van Griensven
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Frits van Griensven.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Guadamuz, T.E., Wimonsate, W., Varangrat, A. et al. HIV Prevalence, Risk Behavior, Hormone Use and Surgical History Among Transgender Persons in Thailand. AIDS Behav 15, 650–658 (2011). https://doi.org/10.1007/s10461-010-9850-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-010-9850-5

Keywords

Search

Navigation