Screening for sexually transmitted infections in the transgender population and interaction of gender-affirming hormonal treatment with antiretroviral therapy.

Introduction: Current evidence suggests that transgender people have a higher risk of sexually transmitted infections (STIs) than general population, although most of the literature focuses on transwomen with HIV.

Objective: To determine the prevalence of STDs diagnosed by serology in transgender population in our hospital and to analyze the impact of antiretroviral treatment on hormonal therapy.

Methods: We design a cross-sectional study based on medical records of transgender people treated at the Transgender Care Unit of Cadiz from June 2022 to June 2023. Hepatitis, HIV and syphilis serology was requested from people between 16 and 65 years.

Results: A total of 295 people were included, 48,14% transwomen (n = 142) and 51,86% transmen (n = 153), with an average age of 24,78 ± 9,2 years. It was detected 14 cases of HAV, 5 of syphilis, 3 of HBV and 3 of HCV. Prevalence of HIV was 3,73% (n = 11). Of the 9 transwomen with HIV infection, 3 of them required a change in antiretroviral medication and 2 cases required changes in the route of estrogen administration to achieve optimal plasma hormone levels.

Conclusions: With the current model of care for transgender people in Andalusia, the prevalence of STDs detected in our sociocultural environment is low. Special attention should be paid to possible interactions between antiretroviral treatment and hormone therapy, especially in transwomen.