Background Previous studies into the sexual health of transgender women (TGW) report high rates of STI and HIV positivity.

Aim To evaluate the sexual health of TGW attending routine GUM clinics in a London Trust.

Methods Retrospective case-note review of TGW attendances from May 2013 to November 2015. Clinical records and laboratory results assessed.

Results 52 attendances were made by 17 TGW with a median age of 31 years (IQR 27–36). 41.2% were European, 52.9% were White and 29.4% were Asian. All had sex with men however 23.5% also had sex with women. 17.6% report sex work in the last year but no unprotected anal intercourse (UAI) with clients. 64.7% report UAI with male partners in the preceding 3 months (90.9% receptive). 64.7% had a history of any STI including 14.3% with Hepatitis B (naturally immune) and 6.7% with HIV. There were no diagnoses of Hepatitis C. The most common diagnosis made during the study period was Syphilis at 26.7% (of which 50% early infection) followed by HPV (23.5%), Chlamydia trachomatis (18.8%), Neisseria gonorrhoea (18.8%) and HSV (17.6%). 35.3% report drug or harmful alcohol use, 5.9% IVDU and 23.5% a history of physical or sexual assault.

Discussion Very high rates of UAI and STIs in TGW are comparable to those seen in previous studies. The prevalence of HIV infection is lower than expected from previous studies, perhaps due to variation in the cohort of TGW seen at our clinics. There remain significant challenges in identifying and providing tailored sexual health services to this at-risk population.