Access to gender-affirming hormone therapy is positively associated with uptake of STI testing.

Abstract

Background Gender-affirming medical care access may improve the STI care continuum for transgender and nonbinary communities. This study examined the association between gender-affirming hormone therapy (GAHT) and uptake of STI testing. Methods The Priority Assessment in Trans Health Project is a community-informed study developed by trans Washingtonians. Data were collected from March to May 2023 through community organizations and media platforms. All recruited participants were included in analysis. Descriptive statistics with chi-squared tests (α =0.05) were conducted to compare group differences. An adjusted multivariable regression model measured the association between current GAHT and STI testing. Differences across STI status were measured descriptively. Results Compared with individuals who did not receive an STI test (n =59), those who had received an STI test in the past year (n =738) were more likely to be: aged 25-29years (48% vs 24%), a woman (86% vs 37%), have private health insurance (81% vs 42%) and currently be using GAHT (78% vs 32%). Individuals who tested positive for an STI (n =34) were more likely to be aged 18-24years (24% vs 11%) and to have public health insurance (50% vs 16%) than those who did not test positive for an STI. GAHT use was significantly associated with increased odds of STI testing engagement (OR4.48, 95% CI: 2.01, 10.26, P =0.0003). Conclusion Our findings suggest the need to explore factors influencing medical gender affirmation and uptake of STI testing and other sexual and reproductive services, and support that access to gender-affirming services can be leveraged for STI prevention.