Background The transgender (TG) population is under-researched. Despite reportedly high rates of HIV and sexually transmitted infections (STIs) among TGs, prevalence of these in TGs has not been systematically reviewed. Our primary objective was to perform a systematic review of the literature for studies reporting laboratory test proven prevalence data of HIV and other STIs among male-to-female (MTF) and female-to-male (FTM) TGs. Given the sexual risk factors traditionally associated with MTFs (e.g. commercial sex work), we hypothesized that HIV/STI prevalence would be higher among MTFs compared to FTMs.

Methods A systematic review of the literature on original English-language research involving HIV and/or STI laboratory testing in TG populations within the last 50 years was performed.

Results Of 32 eligible studies, most focused on MTFs, with only 10 (31%) including data on FTMs. MTFs were exclusively investigated in 22 (69%) of studies. The majority of studies including MTFs were focused on sex workers, with 7 (22%) exclusively evaluated sex workers. HIV data was reported in 31 (97%) of studies. Syphilis data was presented in 18 (56%) studies. Regarding gonorrhea and chlamydia, 15 (47%) studies presented testing data, but only 7 reported urogenital and extragenital results. No studies evaluated trichomoniasis. In MTFs, prevalence of HIV, syphilis, gonorrhea, and chlamydia ranged from 0%–70.3%, 1.4%–50.4%, 0%–29.4%, and 2.7%–24.7%, respectively. In FTMs, prevalence of HIV, syphilis, gonorrhea, and chlamydia ranged from 0%–8.3%, 0%–4.2%, 0%–10.5%, and 0–11.1%, respectively.

Conclusion Literature involving STIs in TG people focuses on the MTF community and HIV. Testing patterns for bacterial STIs are variable, especially for gonorrhea and chlamydia. Per current literature, STIs appear to be more prevalent in MTFs compared to FTMs. Data for STIs in FTMs is limited. These gaps present opportunities for further study involving the epidemiology of STIs in the FTM population and the relevance of extragenital bacterial and parasitic STIs in all TGs.

Disclosure No significant relationships.