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Factors Associated With Syphilis Testing and a History of Syphilis Infection Among a Sample of Transgender Women in Jamaica

Logie, Carmen, H., PhD*†; Wang, Ying, MSW*; Lacombe-Duncan, Ashley, MSW*; Ahmed, Uzma, BA*; Jones, Nicolette, MA; Neil, Ava, BA; Ellis, Tyrone, BA; Levermore, Kandasi, BA; Marshall, Annecka, PhD§; Newman, Peter, A., PhD*

Sexually Transmitted Diseases: March 2018 - Volume 45 - Issue 3 - p 158–162
doi: 10.1097/OLQ.0000000000000715
Original Studies

Background Globally, social inequalities contribute to elevated sexually transmitted infections (STIs) rates among transgender women. High syphilis prevalence has been documented among transgender women in Latin America. Little is known, however, of syphilis testing uptake among transgender women in Jamaica, where homosexuality is criminalized. The study objective was to understand factors associated with opting-in for syphilis testing and a syphilis infection history among transgender women in Jamaica.

Methods We conducted a cross-sectional tablet-based survey of 137 transgender women between March and November 2015 in Jamaica. Bivariate analyses were used to assess differences across sociodemographic, intrapersonal, interpersonal, and structural factors based on syphilis infection history. We conducted univariable and multivariable logistic regression to determine the odds ratio for opting-in for syphilis testing for all factors associated with testing uptake at a P value of less than 0.05 in bivariate analyses, controlling for sociodemographic characteristics.

Results Among 137 participants, 83 (60.6%) opted in for syphilis screening and 8 (9.6%) had positive rapid test results. One quarter of participants (n = 26; 25.2%) reported being HIV positive. Opting-in for syphilis testing was associated with the following: 1 health (HIV-positive serostatus: adjusted odds ratio [AOR], 4.33; 95% confidence interval [CI], 1.31–14.26), 1 intrapersonal (perceived STI risk: AOR, 1.58; 95% CI, 1.04–2.40), 1 interpersonal (childhood sexual abuse: AOR, 2.80; 95% CI, 1.03–7.62), and 1 structural (incarceration: AOR, 0.27; 95% CI, 0.11–0.71) factor.

Conclusions This study identified factors (HIV-positive serostatus, perceived STI risk, childhood sexual abuse, no incarceration history) associated with syphilis testing uptake among transgender women. Findings can inform multilevel STI testing, prevention, and care strategies tailored for transgender women in Jamaica.

A study with transgender women in Jamaica found that 60.6% opted in for syphilis testing. Opting-in was associated with HIV-positive serostatus, risk perception, childhood violence, and no history of incarceration.

From the *Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada; †Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada; ‡Jamaica AIDS Support for Life, Kingston, Jamaica; and §Institute for Gender and Development Studies, University of the West Indies, Mona Campus, Kingston, Jamaica

No conflicts of interest exist.

Supported by Canadian Institutes of Health Research Operating Grant (0000303157; Fund: 495419, Competition 201209). C.H. Logie was also supported by an Ontario Ministry of Research and Innovation Early Researcher Award.

Correspondence: Carmen H. Logie, PhD, Factor-Inwentash Faculty of Social Work, 246 Bloor St West, Toronto, ON, Canada M5S 1V4. E-mail: carmen.logie@utoronto.ca.

Received for publication December 23, 2016, and accepted August 22, 2017.

© Copyright 2018 American Sexually Transmitted Diseases Association