Sexually transmitted infections and risk behaviors among transgender persons (Hijras) of Pune, India

Results: The prevalence of HIV (45.2% in Hijras vs 20% in heterosexual men vs 18.9% in MSM, P , 0.0001) and warts (10.3% vs 4.6% vs 7.0%; P = 0.004) was higher in Hijras as compared with heterosexual men and MSM; whereas that of genital ulcer disease (15.3% vs 32.6% vs 21.5%; P , 0.0001) and discharge (5.4% vs 13.6% vs 9.0%; P , 0.0001) was lower. Hijras were more likely to have received money for sex and have an earlier sexual debut than the comparison groups. In multivariate analysis, receiving money for sex (adjusted odds ratio: 4.49; P , 0.04) and having genital ulcer disease (odds ratio: 3.87; P , 0.08) were independently associated with high HIV prevalence in Hijras. Conclusions: Considering the high HIV and STI burden, it is important to review current prevention strategies and stress the need to engage Hijra community members through appropriate targeted intervention programs.