P04.27 Partner-level associated factors for insertive and receptive condomless anal intercourse among transgender women in lima, peru

Abstract

Introduction Partner type has been associated with condomless anal intercourse (CAI) among TW in Peru. We characterised the relationship between partnership characteristics and receptive (R-CAI) versus insertive CAI (I-CAI) among TW. Methods We analysed cross-sectional, egocentric data from TW screened for a 2012–2014 Partner Management study in Lima, Peru. We included self-identified TW reporting anal intercourse (AI) with at least 1 of their last 3 non-female partners. Generalised estimating equations with Poisson distribution were used to assess prevalence ratios (PR) with 95% CIs for R-CAI and I-CAI during the last sexual encounter by partner type (adjusted for participant education, HIV status, STI history, pre-sex alcohol use, sexual role, and partner sexual role). Results 138 TW (median age 27, IQR: 22–33) provided data on their last sexual encounter with 376 distinct partners (78% reporting 3 partners; 16% reporting 2; 6% reporting 1). Most (65.2%) TW practiced receptive AI exclusively, 3.6% practiced insertive AI exclusively, and 31.2% practiced both. I-CAI was more prevalent than R-CAI among TW with alcohol use disorders, drug use before sex, sexual role strain (performing a different role than preferred), and less than secondary education. I-CAI was more prevalent with transactional sex partners (PR adj : 1.54; p = 0.19; reference: primary partners) and casual partners (PR adj : 1.39; p = 0.31), while R-CAI was more common with stable compared with transactional (PR adj : 0.67, p = 0.06) and casual partners (PR adj : 0.70, p = 0.14). I-CAI was significantly lower among HIV-positive TW (PR adj : 0.53; p = 0.02; reference: HIV-negative), while R-CAI was significantly higher among TW with unknown HIV status (PR adj : 1.91; p = 0.048). Conclusion Examining partner-level I-CAI/R-CAI separately reveals different HIV/STI risk contexts/behaviours among TW. Future studies should explore implications of partner and AI-associated risk behaviours, including experience of sexual role strain and differences in TW’s partner-specific perceptions of HIV/STI risk, sexual intimacy, gender affirmation, transactional sex demands, and condom use agency. Disclosure of interest statement None.