HIV infection among foreign transsexual sex workers in Rome - Prevalence, behavior patterns, and seroconversion rates

Background: The Azienda Sanitaria Locale Roma E (ASL-RME) outpatient clinic is the main reference center in Rome for HIV testing of foreign people. Goal: To define the prevalence and incidence of HIV infection among foreign transsexual sex workers attending the center. Study Design: 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 = 2 3), Most of these transsexuals reported having 5 to 10 partners per day. Th e overall HIV prevalence was 38.2%, which multivariate analysis found to be associated with origin from Brazil and a higher number of sex partners. Th e observed HIV seroconversion rate was 4.1 per 100 person-years, and nonreg ular condom use was the only factor related to seroconversion, Conclusions: The data from this study suggest that promotion of safer sex p ractices and regular condom use still is the main priority among marginaliz ed population subgroups, such as foreign prostitutes, involved in sex activ ities that put them at risk for HIV infection.