Kontakt X:X | DOI: 10.32725/kont.2026.050

Prevalence and factors associated with sexually transmitted infections among transgender individuals receiving gender-affirming care in Brazil: a cross-sectional studyNursing - Original article

Jean Carlos Soares da Silva¹, Isadora Silva de Carvalho ORCID...¹, Lariane Angel Cepas ORCID...¹, Talia Gomes Luz ORCID...¹, Álvaro Francisco Lopes de Sousa ORCID...^{2, 3, *}, Ruan Nilton Rodrigues Melo¹, Caíque Jordan Nunes Ribeiro ORCID...⁴, Telma Maria Evangelista de Araújo ORCID...⁵, Lucia Alves Silva Lara ORCID...⁶, Ana Paula Morais Fernandes ORCID...^{1, 3}

¹ Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, SP, Brazil

² Universidade Federal de Mato Grosso do Sul, Câmpus de Três Lagoas, MS, Brazil

³ NOVA University Lisbon, Comprehensive Health Research Center (CHRC), Public Health Research Centre, Lisbon, Portugal

⁴ Universidade Federal de Sergipe, Campus Lagarto, SE, Brazil

⁵ Universidade Federal do Piauí, Campus Ministro Petronio Portela, PI, Brazil

⁶ Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, SP, Brazil

Introduction: Transgender individuals experience structural inequalities, stigma, and barriers to healthcare, which contribute to a disproportionate burden of sexually transmitted infections (STIs). Evidence on STI occurrence among individuals receiving gender-affirming care remains limited.

Methods: A cross-sectional study was conducted in 2025 at a public gender-affirming outpatient clinic in southeastern Brazil. A convenience sample of 180 transgender individuals completed questionnaires on sociodemographic characteristics, sexual practices, prevention strategies, substance use, and clinical history. Rapid testing for HIV and syphilis was performed. Factors associated with a history of STIs in the previous 12 months were analyzed using hierarchical Poisson regression.

Results: Most participants were younger than 30 years (77.2%), single (87.2%), and had completed at least 12 years of education (94.3%). A history of STIs in the previous 12 months was reported by 21.1% of participants. Awareness and use of PrEP and PEP were limited. Age ≥30 years, transgender woman identity, alcohol use, and PrEP use were independently associated with STI history.

Conclusion: STI vulnerability persists among transgender individuals receiving specialized gender-affirming care and is shaped by structural, contextual, and behavioral factors. Strengthening combined prevention strategies and expanding access to PrEP and PEP are essential to improve sexual health outcomes in this population.

Keywords: HIV; Rapid tests; Sexual health; Sexually transmitted infections; Transgender individuals

Grants and funding:

This research was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, grant #2024/15320-5, 2025/24673-1 and 2025/04763-6); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, grant #405741/2024-3) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, grant #88887.916785/2023-00 and finance code #001).

Conflicts of interest:

The authors have no conflict of interest to declare.

Received: March 19, 2026; Revised: June 11, 2026; Accepted: August 18, 2026; Prepublished online: August 18, 2026