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A meta-analysis estimated the worldwide prevalence of HIV among transgender individuals at 19.1% and found a 48.8-fold increase in the odds of HIV infection compared with non-transgender adults of reproductive age.1 2 Despite such disparities, HIV and STI research has historically grouped transgenders with men who have sex with men (MSM) or excluded them from studies altogether, thus limiting the information available on the social and behavioural factors that increase HIV vulnerability among transindividuals and how these factors may differ from MSM.3 STIs are often associated with stigma, stereotyping, vulnerability and shame.4 Transindividuals face additional barriers to appropriate healthcare access as opposed to cisgender individuals and MSM, for example, requirement for medical interventions such as hormone therapy and/or surgery, paucity of knowledgeable health providers, real or perceived stigma and discrimination from individuals within the healthcare system, greater clinical depression, anxiety and somatisation, and lack of insurance coverage due to socioeconomic limitations.5 Hence transindividuals are often inhibited to seek testing and treatment. WIR - Walk In Ruhr, Center for Sexual Health and Medicine (https://www.wir-ruhr.de) is a premier and unique multidisciplinary, cross-sectoral and interinstitutional model care centre in Germany …
Handling editor Anna Maria Geretti
Contributors AS-R, AP and NB conceived the project and the main conceptual ideas. MB assisted in the development of the survey questionnaire, consistent with standard psychological survey parameters. AKas provided IT support and database management. SN, AKas and MB analysed the survey data. AS-R, AP, NB, SN, JW, AKas and MB aided in verifying the data and interpreting the results. JW and AKay undertook advertisement and promotion of the survey to the target population. AS-R and SN wrote the manuscript. All authors discussed the results, and read and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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