Baseline data of sociodemographic characteristics, sexual behaviour, STI diagnosis and HIV status according to self-identified gender of TGP-AMAB visiting the public health services of Amsterdam and The Hague, the Netherlands, January 2017–December 2018
| Transgender woman n=208 (76.2%) n (%) | Man and woman n=35 (12.8%) n (%) | Neither man nor woman n=10 (3.7%) n (%) | Other n=11 (4.0%) n (%) | Not known yet n=9 (3.3%) n (%) | P value | Total N=273 n (%) | |
| Demographics | |||||||
| Median age in years (IQR) | 34 (27–44) | 35 27–39) | 22 (19–27) | 35 (28–47) | 27 (24–34) | <0.001 | 33 (27–43) |
| Education (n=23 missing) | <0.001 | ||||||
| Low | 20 (10.5) | 0 | 0 | 2 (20.0) | 3 (33.3) | 25 (10.0) | |
| Middle | 35 (18.3) | 9 (30.0) | 9 (90.0) | 1 (10.0) | 1 (11.1) | 55 (22.0) | |
| High | 32 (16.8) | 15 (50.0) | 1 (10.0) | 5 (50.0) | 4 (44.4) | 57 (22.8) | |
| Other | 104 (54.5) | 9 (20.0) | 0 | 2 (20.0) | 1 (11.1) | 113 (45.2) | |
| Ethnic origin* | 0.002 | ||||||
| The Netherlands | 32 (15.4) | 9 (25.7) | 6 (60.0) | 3 (27.3) | 2 (22.2) | 25 (19.0) | |
| Asia | 41 (19.7) | 7 (20.0) | 0 | 0 | 1 (11.1) | 49 (17.9) | |
| Africa | 5 (2.4) | 5 (14.3) | 0 | 0 | 0 | 10 (3.07) | |
| Latin America or the Caribbean | 104 (50.0) | 7 (20.0) | 3 (30.0) | 4 (36.4) | 5 (55.6) | 132 (45.1) | |
| Europe | 25 (12.0) | 6 (17.1) | 1 (10.0) | 4 (36.4) | 1 (11.1) | 37 (13.6) | |
| Unknown | 1 (0.5) | 1 (2.9) | 0 | 0 | 0 | 2 (0.7) | |
| Gender-affirming surgery | |||||||
| Vagina construction | 51 (24.5) | 0 | 0 | 0 | 0 | <0.001 | 51 (18.7) |
| Sexual behaviour in the past 6 months | |||||||
| Median number of sex partners (IQR)† (missing n=26) | 40 (5–275) | 5 (3–35) | 5 (3–17) | 5 (3–13) | 9 (3–31) | <0.001 | 15 (4–200) |
| Sex work (missing n=16) | 125/197 (63.5) | 5/31 (16.1) | 1/10 (10.0) | 5/10 (50.0) | 1/9 (11.1) | <0.001 | 137/257 (53.3) |
| Sex with (missing n=6) | <0.001 | ||||||
| Men | 185 (91.1) | 22 (62.9) | 8 (80.0) | 7 (70.0) | 7 (77.8) | 229 (85.8) | |
| Women | 1 (0.5) | 2 (5.7) | 1 (10.0) | 0 | 0 | 4 (1.5) | |
| Both | 17 (8.4) | 11 (31.4) | 1 (10.0) | 3 (30.0) | 2 (22.2) | 34 (12.7) | |
| Partner type (missing n=27) | 0.002 | ||||||
| Steady only | 8 (4.1) | 1 (3.3) | 1 (11.1) | 0 | 0 | 10 (4.1) | |
| Casual only | 111 (58.7) | 19 (63.3) | 6 (66.7) | 9 (90.0) | 7 (87.5) | 152 (61.8) | |
| Steady and casual | 69 (36.5) | 9 (30.0) | 2 (22.2) | 1 (10.0) | 1 (12.5) | 82 (33.3) | |
| No sex | 1 (0.5) | 1 (3.3) | 0 | 0 | 0 | 2 (0.8) | |
| Giving fellatio‡ | |||||||
| Giving condomless fellatio (n=26 missing) | 106/136 (77.9) | 16/16 (100) | 5/5 (100) | 7/7 (100) | 7/7 (100) | 0.068 | 141/171 (82.5) |
| Anal sex | |||||||
| Condomless receptive anal sex§ (n=29 missing) | 92/155 (59.4) | 12/18 (66.7) | 5/6 (83.3) | 5/9 (55.6) | 6/6 (100) | 0.246 | 120/194 (61.9) |
| Condomless insertive anal sex¶ (n=31 missing) | 46/88 (52.3) | 12/16 (75.0) | 3/4 (75.0) | 4/8 (50.0) | 4/4 (100) | 0.163 | 69/120 (57.5) |
| Vaginal sex (n=14 missing) | |||||||
| Condomless vaginal sex** | 32/48 (66.7) | 6/9 (66.7) | 2/2 (100) | 3/3 (100) | 2/2 (100) | 0.784 | 45/64 (70.3) |
| Bacterial STI | |||||||
| Any bacterial STI†† (n=6 missing) | 28/203 (13.8) | 8/35 (22.9) | 2/10 (20.0) | 0/10 | 2/9 (22.2) | 0.294 | 40/267 (15.0)‡‡ |
| Chlamydia (one or more locations) | 15/203 (7.2) | 6/35 (17.1) | 2/10 (20.0) | 0/10 | 1/9 (11.1) | 0.318 | 24/267 (9.0) |
| Pharyngeal | 2/189 (1.0) | 1/33 (3.0) | 0/8 | 0/10 | 0/9 | 0.550 | 3/258 (1.2) |
| Rectal | 10/197 (5.1) | 5/34 (14.7) | 2/9 (22.2) | 0/10 | 1/9 (11.1) | 0.052 | 18/259 (6.9) |
| Urethral (penis) | 2/154 (1.3) | 2/35 (5.7) | 0/10 | 0/10 | 1/9 (11.1) | 0.159 | 5/218 (2.3) |
| Urethral (neovagina, n=2 missing) | 2/49 (4.1) | NA | NA | NA | NA | 2/49 (4.1) | |
| Gonorrhoea (one or more locations) | 13/203 (6.4) | 2/35 (5.7) | 0/10 | 0/10 | 1/9 (11.1) | 0.826 | 16/267 (6.0) |
| Pharyngeal | 5/199 (2.5) | 2/33 (6.1) | 0/9 | 0/10 | 1/9 (11.1) | 0.290 | 8/260 (3.1) |
| Rectal | 10/197 (5.1) | 1/34 (2.9) | 0/9 | 0/10 | 0/9 | 0.563 | 11/259 (4.2) |
| Urethral (penis) | 0/154 | 0/35 | 0/10 | 0/10 | 0/9 | 0/218 | |
| Urethral (neovagina, n=2 missing) | 0/49 | NA | NA | NA | NA | 0/49 | |
| Infectious syphilis (n=9 missing) | 3/201 (1.5) | 1/35 (2.9) | 0/9 | 0/10 | 0/9 | 0.666 | 4/264 (1.5) |
| HIV (n=6 missing) | 0.164 | ||||||
| Opt-out | 4/203 (2.0) | 1/35 (2.9) | 1/10 (10.0) | 0/10 | 0/9 | 6/267 (2.2) | |
| Known positive | 31/203 (15.3) | 3/35 (8.6) | 0 | 1/10 (10.0) | 2/9 (22.2) | 37/267 (13.9) | |
| Negative tested | 168/203 (82.8) | 29/35 (82.9) | 9/10 (90.0) | 9/10 (90.0) | 7/9 (77.8) | 222/267 (83.1) | |
| Positive tested | 0 | 2/35 (5.7) | 0 | 0 | 0 | 2/267 (0.7)‡‡ |
*Ethnicity was defined according to Statistics Netherlands on the basis of country of birth, maternal and paternal countries of birth.26
†Giving fellatio, vaginal and/or anal sex.
‡Among those who reported giving fellatio (only data from Amsterdam).
§Among those who reported receptive anal sex with men.
¶Among those who reported insertive anal sex and currently have a penis.
**Among those who reported vaginal sex and currently having a vagina and having sex with men or if currently having a penis and having sex with women.
††Bacterial STI: chlamydia, gonorrhoea and/or infectious syphilis.
‡‡New diagnoses among TGP-AMAB who have been tested for HIV 0.9% (2/224).
NA, not applicable; TGP-AMAB, transgender people assigned male at birth.