title: HIV infection among foreign transsexual sex workers in Rome: prevalence, behavior patterns, and seroconversion rates.
abstract: BACKGROUND
  The Azienda Sanitaria Locale Roma E (ASL-RME) outpatient clinic is the main reference center in Rome for HIV testing of foreign people.
  
  
  OBJECTIVE
  To define the prevalence and incidence of HIV infection among foreign transsexual sex workers attending the center.
  
  
  METHODS
  A cross-sectional, follow-up study was conducted.
  
  
  RESULTS
  Between 1993 and 1999, 353 transsexuals attended the ASL-RME. They were from Colombia (n = 208), Brazil (n = 122), and other countries (n = 23). Most of these transsexuals reported having 5 to 10 partners per day. The overall HIV prevalence was 38.2%, which multivariate analysis found to be associated with origin from Brazil and a higher number of sex partners. The observed HIV seroconversion rate was 4.1 per 100 person-years, and non-regular condom use was the only factor related to seroconversion.
  
  
  CONCLUSIONS
  The data from this study suggest that promotion of safer sex practices and regular condom use still is the main priority among marginalized population subgroups, such as foreign prostitutes, involved in sex activities that put them at risk for HIV infection.
authors.affiliation: Unità Operativa AIDS, Azienda Sanitaria Locale Roma E (ASL-RME), Rome, Italy. lspizzi@bigfoot.com
authors.forename: L
authors.initials: L
authors.lastname: Spizzichino
authors.forename: M
authors.initials: M
authors.lastname: Zaccarelli
authors.forename: G
authors.initials: G
authors.lastname: Rezza
authors.forename: G
authors.initials: G
authors.lastname: Ippolito
authors.forename: A
authors.initials: A
authors.lastname: Antinori
authors.forename: P
authors.initials: P
authors.lastname: Gattari
mesh_terms: D000328:Adult; D001938:Brazil / Q000208:ethnology; D003105:Colombia / Q000208:ethnology; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology*; D015528:HIV Seroprevalence; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D020380:Needs Assessment; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012307:Risk Factors; D012384:Rome / Q000453:epidemiology; D012736:Sex Education; D011477:Sex Work / Q000523:psychology* / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data*; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D014189:Transsexualism / Q000523:psychology*