Migração e HIV entre travestis e mulheres trans no nordeste do Brasil.

Abstract

Introduction: The HIV epidemic remains disproportionately high among travestis and transgender women (TrTGW) in Brazil. TrMT face significant stigma and gender discrimination, factors that not only heighten their vulnerability to HIV but also may contribute to increased migration within this population, as they flee degrading environments or seek better means of livelihood. This study estimated the prevalence of HIV and its associated factors, while also investigating the effect of migration on the likelihood of HIV infection among TrTGW in three capital cities of Northeast Brazil. Methods: Data from two cross-sectional studies involving TrTGW were used. These studies were conducted between 2014-2016 in Salvador (PopTrans) and 2016-2017 in Salvador, Recife, and Fortaleza (DIVAS). Both studies employed Respondent Driven Sampling (RDS) methodology. Third-generation rapid HIV tests were administered in accordance with the Ministry of Health's HIV testing protocol. The prevalence of HIV and associated factors were estimated using logistic regression in both studies conducted in Salvador. A scoping review of national and international studies on the relationship between migration and HIV infection among transgender women was also developed. Binomial logistic regression, stratified by age, was used to assess the effect of internal migration on HIV infection, adjusted for potential confounding factors. Results: The estimated HIV prevalence in Salvador was 9.0% in the PopTrans study and 24.3% in the DIVAS study. Factors such as family and neighbor discrimination, as well as a history of syphilis infection, were significantly associated with HIV infection. The scoping review included eight studies and indicated that migration is associated with a higher likelihood of HIV infection due to riskier behaviors or limited access to healthcare services. Internal migration increased the likelihood of HIV infection, particularly among TrTGW over 35 years of age. Conclusion: The high vulnerability to HIV among TrTGW, exacerbated by migration, highlights the urgent need for services and initiatives that enhance access to information, prevention, care, and treatment, combat discrimination, and decentralize health services for transgender individuals.