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P4.20 Factors associated with opting in for clinic-based syphilis testing among transgender women in jamaica
  1. Carmen Logie1,
  2. Kathleen Kenny2,
  3. Peter A Newman3,
  4. Kandasi Levermore4,
  5. Nicolette Jones5,
  6. Ava Neil4,
  7. Tyrone Ellis4,
  8. Annecka Marshall6
  1. 1University of Toronto, Toronto, Canada, Canada
  2. 2University of North Carolina, Chapel Hill, Chapel Hill, US
  3. 3University of Toronto, Toronto, Canada
  4. 4Jamaica AIDS Support for Life, Kingston – Jamaica
  5. 5Jamaica AIDS Support for Life, Kingston, Canada
  6. 6University of West Indies, Mona Campus, Kingston – Jamaica


Introduction Transgender women experience high sexually transmitted infection (STI) rates, yet there is a lack of information about STI testing uptake among transgender women in low and middle-income countries. We conducted a tablet-based survey to assess syphilis testing uptake and prevalence among transgender women in Jamaica.

Methods We conducted a cross-sectional survey with a peer-driven recruitment sample of transgender women in Kingston and Ocho Rios, Jamaica. Participants were provided with a coupon with their survey identification (ID) code for voluntary, free, rapid serological syphilis testing. Coupon ID codes for testing uptake/results were linked with survey results. We conducted backwards stepwise logistic regression to determine factors associated with opting in for syphilis testing.

Results Among 137 participants (mean age: 24.0 [SD: 4.5]), 60.6% opted in for syphilis testing and 10.6% tested positive. One-quarter (25.2%) self-reported being HIV-positive; all participants with syphilis infection were HIV-positive. In univariable analyses having multiple partners was associated with reduced odds of opting in for testing (OR: 0.19; 95% CI: 0.06–0.60). In multivariable analyses controlling for relationship status, HIV-positive participants were four-fold more likely to opt-in for syphilis testing (Adjusted Odds Ratio [AOR: 4.33]; 95% CI: 1.31–14.26) than HIV-negative participants. Perceived STI risk (AOR: 1.58; 95% CI: 1.04–2.40) and childhood sexual abuse history (AOR: 2.80; 95% CI: 1.03–7.62) were associated with increased odds of opting in for testing. Incarceration history (AOR: 0.27; 95% CI: 0.11–0.71) was associated with reduced odds of opting in for syphilis testing.

Conclusion Transgender women in Jamaica experience high HIV and syphilis prevalence, and syphilis and HIV co-infection. Findings suggest opt-in clinic based syphilis testing may miss the opportunity to provide testing for some transgender women at elevated STI risk. Future research should assess whether point-of-care syphilis testing may increase testing uptake.

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