title: HIV-related sexual risk behaviors among male-to-female transgender people in Nepal.
abstract: BACKGROUND
  Transgender women are a vulnerable and key risk group for HIV, and most research has shown an increased frequency of HIV infection among this minority population. This study examined the prevalence of HIV-related sexual risk behaviors and the socio-demographic correlates with HIV-related sexual risk behaviors among male-to-female (MtF) transgender persons.
  
  
  METHODS
  Data were collected from a sample of 232 individuals through venue-based and snowball sampling and face-to-face interviews.
  
  
  RESULTS
  The HIV-related sexual risk behaviors among the MtF transgender persons were: sex without using a condom (48.3%; 95% confidence interval (CI) 41.8-54.8), unprotected anal sex (68.1%; 95% CI 62.0-74.2), and unprotected sex with multiple partners (88.4%; 95% CI 84.3-92.5). Statistically significant differences were found for age, income, education, alcohol habit, and sex with more than two partners per day for these three different HIV-related sexual risk behaviors. MtF transgender persons with a secondary or higher level of education were three times (OR 2.93) more likely to have unprotected sex with multiple partners compared to those with a primary level or no education.
  
  
  CONCLUSIONS
  Age, education, income, frequency of daily sexual contact, and an alcohol habit remain significant with regard to HIV-related sexual risk behavior. There is an urgent need for programs and interventions to reduce risky sexual behaviors in this minority population.
authors.affiliation: Department of Public Health, Pokhara University, Nobel College, Sinamangal, Kathmandu, Nepal. Electronic address: dnbhatta@yahoo.com.
authors.forename: Dharma Nand
authors.initials: DN
authors.lastname: Bhatta
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017280:Condoms / Q000706:statistics & numerical data; D004493:Education; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009390:Nepal; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D063106:Transgender Persons; D047568:Unsafe Sex / Q000517:prevention & control / Q000523:psychology*
keywords: HIV risk behavior; Male to female; MtF; Nepal; Transgender; Unprotected sex