Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Sexually transmitted infection testing among transgender and non-binary persons: results of a community-based cross-sectional survey

Ashley Lacombe-Duncan https://orcid.org/0000-0002-9023-8877 A * , Shanna K. Kattari A B , Leonardo Kattari C , Ayden I. Scheim D and Brayden A. Misiolek E
+ Author Affiliations
- Author Affiliations

A University of Michigan, School of Social Work, Ann Arbor, MI, USA.

B University of Michigan, Department of Women’s and Gender Studies, Ann Arbor, MI, USA.

C Michigan State University, School of Social Work, East Lansing, MI, USA.

D Drexel University, Dornsife School of Public Health, Philadelphia, PA, USA.

E Transcend the Binary, Ferndale, MI, USA.

* Correspondence to: lacombed@umich.edu

Handling Editor: Heather Armstrong

Sexual Health 20(1) 87-91 https://doi.org/10.1071/SH22128
Submitted: 10 August 2022  Accepted: 15 October 2022   Published: 9 November 2022

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background: Studies show higher rates of sexually transmitted infections (STIs) among transgender (trans) and non-binary (TNB) persons compared with the general population. Scant studies have examined non-HIV STI testing (henceforth referred to as STI testing); fewer inclusive of trans men and non-binary persons. We characterised the prevalence of STI testing and time since last STI test and gender-based differences in these outcomes among TNB persons.

Methods: Data were analysed from a 2018 community-based participatory cross-sectional survey (n = 528). Prevalence of lifetime STI testing history and time since last STI test were reported overall and compared across genders (trans men, trans women, non-binary assigned female at-birth, non-binary assigned male at-birth) using Chi-squared, then bivariable and multivariable logistic regression analyses to compare lifetime STI testing history (ever vs never) across sociodemographic and health care characteristics.

Results: Most (n = 425; 80.5%) participants reported having ever had an STI test; over half (59.8%) ever tested had tested within the past year. Bivariate analyses showed no significant gender differences in lifetime STI testing history (P = 0.298) or time since last STI test (P = 0.118). In a multivariable model, higher age, reporting multiple committed partners (vs single/divorced), known HIV status, and ever receiving information about pre-exposure prophylaxis (PrEP) were positively associated with ever having had an STI test, whereas Latinx race/ethnicity (vs white) was negatively associated.

Conclusions: Findings showed high rates of lifetime STI testing and recent testing, with no gender-based differences. Never testing rates were concerning considering screening recommendations. Broad based (non-gender specific) TNB-focused interventions may be warranted to increase uptake.

Keywords: agender, gender diverse, genderqueer, sexual health, STI screening, STI testing, trans men, trans women, transgender.


References

[1]  Centers for Disease Control and Prevention. CDC fact sheet: incidence, prevalence, and cost of sexually transmitted infections in the United States; 2021. Available at https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/2018-STI-incidence-prevalence-factsheet.pdf [Accessed 18 June 2022]

[2]  Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2018; 2019. Available at https://www.cdc.gov/std/stats18/STDSurveillance2018-full-report.pdf [Accessed 18 June 2022]

[3]  Trujillo D, Arayasirikul S, Xie H, et al. Disparities in sexually transmitted infection testing and the need to strengthen comprehensive sexual health services for trans women. Transgend Health 2022; 7 230–36.
Disparities in sexually transmitted infection testing and the need to strengthen comprehensive sexual health services for trans women.Crossref | GoogleScholarGoogle Scholar |

[4]  James SE, Herman JL, Rankin S, etal. The report of the 2015 U.S. transgender survey. Washington, DC: National Center for Transgender Equality; 2016.

[5]  Van Gerwen OT, Jani A, Long DM, et al. Prevalence of sexually transmitted infections and human immunodeficiency virus in transgender persons: a systematic review. Transgend Health 2020; 5 90–103.
Prevalence of sexually transmitted infections and human immunodeficiency virus in transgender persons: a systematic review.Crossref | GoogleScholarGoogle Scholar |

[6]  Tsevat DG, Wiesenfeld HC, Parks C, et al. Sexually transmitted diseases and infertility. Am J Obstet Gynecol 2017; 216 1–9.
Sexually transmitted diseases and infertility.Crossref | GoogleScholarGoogle Scholar |

[7]  Sharma A, Kahle E, Todd K, et al. Variations in testing for HIV and other sexually transmitted infections across gender identity among transgender youth. Transgend Health 2019; 4 46–57.
Variations in testing for HIV and other sexually transmitted infections across gender identity among transgender youth.Crossref | GoogleScholarGoogle Scholar |

[8]  Antebi-Gruszka N, Talan AJ, Reisner SL, et al. Sociodemographic and behavioural factors associated with testing for HIV and STIs in a US nationwide sample of transgender men who have sex with men. Sex Transm Infect 2020; 96 422–27.
Sociodemographic and behavioural factors associated with testing for HIV and STIs in a US nationwide sample of transgender men who have sex with men.Crossref | GoogleScholarGoogle Scholar |

[9]  Kutner BA, Zucker J, López-Rios J, et al. Infrequent STI testing in New York City among high risk sexual and gender minority individuals interested in self- and partner-testing. AIDS Behav 2022; 26 1153–62.
Infrequent STI testing in New York City among high risk sexual and gender minority individuals interested in self- and partner-testing.Crossref | GoogleScholarGoogle Scholar |

[10]  Rosenberg S, Callander D, Holt M, et al. Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: findings from the Australian Trans & Gender Diverse Sexual Health Survey. PLoS ONE 2021; 16 e0253589
Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: findings from the Australian Trans & Gender Diverse Sexual Health Survey.Crossref | GoogleScholarGoogle Scholar |

[11]  Tordoff DM, Morgan J, Dombrowski JC, et al. Increased ascertainment of transgender and non-binary patients using a 2-step versus 1-step gender identity intake question in an STD clinic setting. Sex Transm Dis 2019; 46 254–59.
Increased ascertainment of transgender and non-binary patients using a 2-step versus 1-step gender identity intake question in an STD clinic setting.Crossref | GoogleScholarGoogle Scholar |

[12]  Kattari SK, Curley KM, Bakko M, et al. Development and validation of the trans-inclusive provider scale. Am J Prev Med 2020; 58 707–14.
Development and validation of the trans-inclusive provider scale.Crossref | GoogleScholarGoogle Scholar |

[13]  Workowski KA, Bolan GA, Centers for Disease Control and Prevention Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64 1–137.

[14]  Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep 2021; 70 1–187.
Sexually transmitted infections treatment guidelines, 2021.Crossref | GoogleScholarGoogle Scholar |

[15]  Pitasi MA, Kerani RP, Kohn R, et al. Chlamydia, gonorrhea, and human immunodeficiency virus infection among transgender women and transgender men attending clinics that provide sexually transmitted disease services in six US cities: results from the sexually transmitted disease surveillance network. Sex Transm Dis 2019; 46 112–7.
Chlamydia, gonorrhea, and human immunodeficiency virus infection among transgender women and transgender men attending clinics that provide sexually transmitted disease services in six US cities: results from the sexually transmitted disease surveillance network.Crossref | GoogleScholarGoogle Scholar |

[16]  Todd K, Peitzmeier SM, Kattari SK, et al. Demographic and behavioral profiles of nonbinary and binary transgender youth. Transgend Health 2019; 4 254–61.
Demographic and behavioral profiles of nonbinary and binary transgender youth.Crossref | GoogleScholarGoogle Scholar |

[17]  Palmer-Wackerly AL, Chaidez V, Wayment C, et al. Listening to the voices of community health workers: a multilevel, culture-centered approach to overcoming structural barriers in U.S. Latinx communities. Qual Health Res 2020; 30 423–36.
Listening to the voices of community health workers: a multilevel, culture-centered approach to overcoming structural barriers in U.S. Latinx communities.Crossref | GoogleScholarGoogle Scholar |

[18]  Poteat T, Wirtz A, Malik M, et al. A gap between willingness and uptake: findings from mixed methods research on HIV prevention among black and Latina transgender women. J Acquir Immune Defic Syndr 2019; 82 131–40.
A gap between willingness and uptake: findings from mixed methods research on HIV prevention among black and Latina transgender women.Crossref | GoogleScholarGoogle Scholar |

[19]  Khosropour CM, Broad JM, Scholes D, et al. Estimating chlamydia screening coverage: a comparison of self-report and Healthcare Effectiveness Data and Information Set (HEDIS) measures. Sex Transm Dis 2014; 41 665–70.
Estimating chlamydia screening coverage: a comparison of self-report and Healthcare Effectiveness Data and Information Set (HEDIS) measures.Crossref | GoogleScholarGoogle Scholar |

[20]  Royer HR, Falk EC, Heidrich SM. Sexually transmitted disease testing misconceptions threaten the validity of self-reported testing history. Public Health Nurs 2013; 30 117–27.
Sexually transmitted disease testing misconceptions threaten the validity of self-reported testing history.Crossref | GoogleScholarGoogle Scholar |