Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transg...Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transgender patients. Few studies address the successful implementation of transgender healthcare teaching and education in graduate medical education. Purpose: The purpose was to design an online asynchronous curriculum to address the need for improved transgender healthcare education in graduate medical education and assess change in knowledge and comfort in transgender healthcare for residents and fellow learners. Methods: A 6-module curriculum was developed using established guidelines and ACGME competencies as a framework for content. To assess curriculum effectiveness, participants received anonymous pre- and post-curriculum surveys which included a multiple-choice knowledge assessment, Likert scale comfort questions focusing on healthcare skills, and open-ended feedback questions. Results: Twenty-six internal medicine residents and fellows participated in the curriculum (2022-2023). There was a 69% post-survey response rate. Participants improved their gender-affirming knowledge after completing the curriculum (p Conclusion: This online curriculum was successful in increasing knowledge and comfort in transgender care for IM residents and fellows. It provides a promising framework to address this gap in curricular content.展开更多
Background Previous studies have shown evidence of health-related risk behaviors among women who have sex with women （WSW）, such as sex with men, multiple bisexual partners, and drug use. Women who have sex with wom...Background Previous studies have shown evidence of health-related risk behaviors among women who have sex with women （WSW）, such as sex with men, multiple bisexual partners, and drug use. Women who have sex with women have also been known to avoid routine physical examinations and conceal their same-sex history from physicians, which can affect their ability to receive an accurate diagnosis and treatment. No previous research has targeted women who have sex with women in China. We sought to describe women who have sex with women in China and explore risk factors for their reproductive tract infections （RTI）/sexually transmitted infections （STI）. Methods Participants were recruited through outreach in venues and online for a cross-sectional study. Data were collected using interviews and laboratory tests. Results We recruited 224 women who have sex with women. In the year preceding their participation in the study, 92% （206/224） of women reported sexual relations with women. The RTI rates were： gonorrhea （15.8%）, chlamydia （3.5%）, syphilis （0.5%）, bacterial vaginosis （14.4%）, hepatitis B virus （HBV） （0.9%）, hepatitis C virus （HCV） （0.5%）, and candidiasis （6.9%）. No HIV or herpes simplex virus （HSV） positive cases were detected. Factors associated with gonorrhea infection were non-Beijing local residency （odds ratio （OR）=2.1, 95% confidence interval （C/）： 1.2-3.8） and genital-genital contact （OR=3.1, 95% CI： 1.3-7.2）; factors associated with curable STI （excluding bacterial vaginosis, candidiasis, HBV and HCV） were non-Beijing local residency （OR=1.9; 95% CI： 1.2-3.0） and bleeding during or after sex （OR=18.1; 95% CI： 5.2-62.6）; and the factor associated with RTI （including all the infections tested） was bleeding during or after sex （OR=37.8, 95% CI： 11.2-127.4）. Conclusions Behaviors that may cause RTI/STI exist among Chinese women who have sex with women. Researchers should consider these behaviors when plannin展开更多
Background and Aims:The Union Cycliste Internationale has deemed transgender female athlete’s ineligible for the female category due to concerns about performance advantages.We conducted a follow-up analysis on labor...Background and Aims:The Union Cycliste Internationale has deemed transgender female athlete’s ineligible for the female category due to concerns about performance advantages.We conducted a follow-up analysis on laboratorybased performance indicators of sports performance using data from a longitudinally assessed transgender woman athlete undergoing gender-affrming hormone therapy(GAHT).Methods:We evaluated laboratory performance indicators in transgender and cisgender women athletes using dualenergy X-ray absorptiometry scanning,handgrip strength measurement,jump testing,and cardiopulmonary exercise.Additionally,we assessed a transgender sub-elite cyclist before and after undergoing GAHT.Results:After one year of GAHT,the transgender athlete showed declines in handgrip strength(7–13%),countermovement jump(23–29%),and V̇O_(2)max(15–30%).After 3 months,several performance indicators(absolute handgrip,peak power,relative peak power,average power,relative average power,V̇O2max and relative V̇O_(2)max)were above the mean of cisgender female athletes,while others(Relative handgrip,countermovement jump and relative countermovement jump)were below.Similar trends were observed at 6 months and 1 year.Summary:This hypothetical analysis,although with limited evidence,suggests the transgender athlete could compete equitably in elite cycling events within the female category after one year of GAHT.Adjustments based on competition data would ensure fairness.Further analysis after an additional 12 months is recommended to assess the impact of 2 years of GAHT.An outright ineligibility for the female category for transgender women athletes would hinder a true assessment of performance fairness.展开更多
Background: The degree to which one identifies as male or female has a profound impact on one’s life. Yet, there is a limited understanding of what contributes to this important characteristic termed gender identity....Background: The degree to which one identifies as male or female has a profound impact on one’s life. Yet, there is a limited understanding of what contributes to this important characteristic termed gender identity. In order to reveal factors influencing gender identity, studies have focused on people who report strong feelings of being the opposite sex, such as male-to-female (MTF) transsexuals. Method: To investigate potential neuroanatomical variations associated with transsexualism, we compared the regional thickness of the cerebral cortex between 24 MTF transsexuals who had not yet been treated with cross-sex hormones and 24 age-matched control males. Results: Results revealed thicker cortices in MTF transsexuals, both within regions of the left hemisphere (i.e., frontal and orbito-frontal cortex, central sulcus, perisylvian regions, paracentral gyrus) and right hemisphere (i.e., pre-/post-central gyrus, parietal cortex, temporal cortex, precuneus, fusiform, lingual, and orbito-frontal gyrus). Conclusion: These findings provide further evidence that brain anatomy is associated with gender identity, where measures in MTF transsexuals appear to be shifted away from gender-congruent men.展开更多
Transgender people sometimes use cross-sex hormones without medical supervision. The use of cross-sex hormones, as well as the functional health and mental well-being, among male-to-female transgendered people （＇kat...Transgender people sometimes use cross-sex hormones without medical supervision. The use of cross-sex hormones, as well as the functional health and mental well-being, among male-to-female transgendered people （＇kathoeys＇） in Chiang Mai, Thailand, was studied. Sixty kathoeys were interviewed regarding their use of cross-sex hormones and their familyrelationships. Individuals also completed the Life Orientation Test Revised （LOT-R） to assess dispositional optimism, the Social Functioning Questionnaire （SFQ） and the Short Form Health Survey 36 （SF-36）. Three categories were established as follows： those who never cross-dress, those who sometimes cross-dress and those who always cross-dress in public. Of the 60 subjects, 44 had used hormones for prolonged periods （9.7＋6.1 years）. Their use was related to the permanence of cross-dressing but unrelated to functional health and mental well-being. Fifty percent of subjects had overdosed on commonly used oral contraceptives. Three people used injectable oestrogen in a higher-than-recommended dose. Self-acceptance was high or reasonably good （83%） compared to no acceptance （17%）, and neither was related to the permanence of cross-dressing. Their acceptance by parents and siblings was also relatively high （85% and 89%, respectively）. The permanence of cross-dressing had no effect on the scores of optimism, SF-36 scores and social functioning. Acceptance by oneself or one＇s parents did not seem to affect most aspects of functional health and mental well-being, but non-acceptance by siblings generated lower scores on the social functioning and general mental health subscales. Stressors tended to include physical rather than social factors. In conclusion, the unsupervised use of cross-sex hormones was common among kathoeys, and 50% of the sample had overdosed on them. Acceptance was relatively good, except by siblings. New strategies are needed for a more responsible use of cross-sex hormones.展开更多
Transgender(trans)Filipinos are disproportionately vulnerable to health problems because of the inaccessibility of essential healthcare services resulting from the invisibility and exclusion of trans health in Philipp...Transgender(trans)Filipinos are disproportionately vulnerable to health problems because of the inaccessibility of essential healthcare services resulting from the invisibility and exclusion of trans health in Philippine health and related social institutions.Because of the institutional prejudice and discrimination against trans Filipinos in Philippine society,an intersectional approach presents an opportunity to analyze the invisibility and potentially elucidate the unique health needs of trans Filipinos.This article elucidates how the invisibility of trans Filipinos in health is a product of co-existing and interacting prejudiced and discriminatory institutions,such as the law,education,and medicine,where the historical experiences of colonization,the hegemony of cisgenderism,and the impact of capitalism remain salient.By elucidating these co-existing and interacting structures and forces,this article highlights the gaps in the Philippine healthcare system,such as the lack of affirming and protective policies for trans health and the limited cul-tural competence of healthcare providers.In light of these,future research and policy work must work towards inte-grating gender-specific and gender-inclusive approaches,centering the voices of trans Filipinos in health discourses,and decolonizing and expanding the local understanding of trans health among Filipinos.展开更多
BACKGROUND Transgender individuals receiving masculinising or feminising gender-affirming hormone therapy with testosterone or estradiol respectively,are at increased risk of adverse cardiovascular outcomes,including ...BACKGROUND Transgender individuals receiving masculinising or feminising gender-affirming hormone therapy with testosterone or estradiol respectively,are at increased risk of adverse cardiovascular outcomes,including myocardial infarction and stroke.This may be related to the effects of testosterone or estradiol therapy on body composition,fat distribution,and insulin resistance but the effect of genderaffirming hormone therapy on these cardiovascular risk factors has not been extensively examined.AIM To evaluate the impact of gender-affirming hormone therapy on body composition and insulin resistance in transgender individuals,to guide clinicians in minimising cardiovascular risk.METHODS We performed a review of the literature based on PRISMA guidelines.MEDLINE,Embase and PsycINFO databases were searched for studies examining body composition,insulin resistance or body fat distribution in transgender individuals aged over 18 years on established gender-affirming hormone therapy.Studies were selected for full-text analysis if they investigated transgender individuals on any type of gender-affirming hormone therapy and reported effects on lean mass,fat mass or insulin resistance.RESULTS The search strategy identified 221 studies.After exclusion of studies that did not meet inclusion criteria,26 were included(2 cross-sectional,21 prospectiveuncontrolled and 3 prospective-controlled).Evidence in transgender men suggests that testosterone therapy increases lean mass,decreases fat mass and has no impact on insulin resistance.Evidence in transgender women suggests that feminising hormone therapy(estradiol,with or without anti-androgen agents)decreases lean mass,increases fat mass,and may worsen insulin resistance.Changes to body composition were consistent across almost all studies:Transgender men on testosterone gained lean mass and lost fat mass,and transgender women on oestrogen experienced the reverse.No study directly contradicted these trends,though several small studies of short duration reported no changes.Resu展开更多
Objective: The main objective of this study is to evaluate the prevalence of HIV infection among the clients attending ICTC, Gauhati Medical College & Hospital, Guwahati, for a period of seven years, i.e., from Ap...Objective: The main objective of this study is to evaluate the prevalence of HIV infection among the clients attending ICTC, Gauhati Medical College & Hospital, Guwahati, for a period of seven years, i.e., from April 2008 to March 2015. Material & Method: A total of 40,983 clients attended ICTC, Gauhati Medical College & Hospital from the year 2008 to 2015. Serum samples were collected after taking informed consent and pre-test counseling. In India for all ICTCs, NACO (National AIDS Control Organization), a national guidelines has been followed for HIV testing, reporting and release of results with post test counseling. Results: Of the total 40,983 clients tested for HIV infection, 1919 (4.68%) were found to be HIV seropositive. Seropositivity was higher in male clients i.e. 1314 (68.47%) than female i.e. 604 (31.47%) followed by transgender (TG), i.e., 1 (0.0005%). Heterosexual route of transmission was the major route seen in 1666 clients (86.81%). Maximum HIV seropositivity was in the age group of 45 - 49 years (43.62%). Conclusion: HIV prevalence of 4.68 % among the clients attending ICTC, Gauhati Medical College & Hospital, Guwahati, puts the spotlight on the HIV burden in this part of the country and suggests the need for the scaling up of focused prevention efforts in high-risk groups.展开更多
Objective: The purpose of this study is to estimate the prevalence of HIV infection among the clients attending ICTC, LHMC of New Delhi, for a period of five years, i.e., from 2008 to 2012. Material & Method: A to...Objective: The purpose of this study is to estimate the prevalence of HIV infection among the clients attending ICTC, LHMC of New Delhi, for a period of five years, i.e., from 2008 to 2012. Material & Method: A total of 25,413 clients attended ICTC, LHMC from the year 2008 to 2012. Serum samples were collected after taking informed consent and pre-test counseling. In India for all ICTCs, NACO (National AIDS Control Organization), a national guidelines has been followed for HIV testing, reporting and release of results with post test counseling. Results: Out of the total 25,413 clients tested for HIV infection, 963 (3.78%) were found to be HIV-1 seropositive. Seropositivity was higher in male clients i.e. 625 (64.4%) than female i.e. 336 (34.8%) followed by transgender (TG), i.e., 2 (0.2%). Heterosexual route of transmission was the major route seen in 676 clients (70.1%). Maximum HIV seropositivity was in the age group of 25 - 34 years (35.4%). No HIV-2 case was found among the studied population. Conclusion: HIV prevalence of 3.78% among the clients attending ICTC, LHMC, New Delhi, puts light on the burden on HIV in this part of the country and suggests the need for the scaling up of focused prevention efforts in high-risk groups.展开更多
In comparison to the arduous process of rights advocacy in Hong Kong, transsexuals in China＇s mainland achieved their right to marry via some ＂silent changes＂ there was no legal activism from transsexual communitie...In comparison to the arduous process of rights advocacy in Hong Kong, transsexuals in China＇s mainland achieved their right to marry via some ＂silent changes＂ there was no legal activism from transsexual communities, no debates or hearings in the legislature, and no landmark judgments made by the judiciary. From a perspective of comparative law, transsexuals＇ right It endeavors to dis this article attempts to analyze the legal changes regarding to marry in China＇s mainland in light of the struggles in Hong Kong. cuss to what extent the seemingly ＂smooth＂ and ＂unintended＂ way of opening up marriage to transsexuals in China＇s mainland could be beneficial to trans rights and equality in general.展开更多
文摘Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transgender patients. Few studies address the successful implementation of transgender healthcare teaching and education in graduate medical education. Purpose: The purpose was to design an online asynchronous curriculum to address the need for improved transgender healthcare education in graduate medical education and assess change in knowledge and comfort in transgender healthcare for residents and fellow learners. Methods: A 6-module curriculum was developed using established guidelines and ACGME competencies as a framework for content. To assess curriculum effectiveness, participants received anonymous pre- and post-curriculum surveys which included a multiple-choice knowledge assessment, Likert scale comfort questions focusing on healthcare skills, and open-ended feedback questions. Results: Twenty-six internal medicine residents and fellows participated in the curriculum (2022-2023). There was a 69% post-survey response rate. Participants improved their gender-affirming knowledge after completing the curriculum (p Conclusion: This online curriculum was successful in increasing knowledge and comfort in transgender care for IM residents and fellows. It provides a promising framework to address this gap in curricular content.
文摘Background Previous studies have shown evidence of health-related risk behaviors among women who have sex with women （WSW）, such as sex with men, multiple bisexual partners, and drug use. Women who have sex with women have also been known to avoid routine physical examinations and conceal their same-sex history from physicians, which can affect their ability to receive an accurate diagnosis and treatment. No previous research has targeted women who have sex with women in China. We sought to describe women who have sex with women in China and explore risk factors for their reproductive tract infections （RTI）/sexually transmitted infections （STI）. Methods Participants were recruited through outreach in venues and online for a cross-sectional study. Data were collected using interviews and laboratory tests. Results We recruited 224 women who have sex with women. In the year preceding their participation in the study, 92% （206/224） of women reported sexual relations with women. The RTI rates were： gonorrhea （15.8%）, chlamydia （3.5%）, syphilis （0.5%）, bacterial vaginosis （14.4%）, hepatitis B virus （HBV） （0.9%）, hepatitis C virus （HCV） （0.5%）, and candidiasis （6.9%）. No HIV or herpes simplex virus （HSV） positive cases were detected. Factors associated with gonorrhea infection were non-Beijing local residency （odds ratio （OR）=2.1, 95% confidence interval （C/）： 1.2-3.8） and genital-genital contact （OR=3.1, 95% CI： 1.3-7.2）; factors associated with curable STI （excluding bacterial vaginosis, candidiasis, HBV and HCV） were non-Beijing local residency （OR=1.9; 95% CI： 1.2-3.0） and bleeding during or after sex （OR=18.1; 95% CI： 5.2-62.6）; and the factor associated with RTI （including all the infections tested） was bleeding during or after sex （OR=37.8, 95% CI： 11.2-127.4）. Conclusions Behaviors that may cause RTI/STI exist among Chinese women who have sex with women. Researchers should consider these behaviors when plannin
文摘Background and Aims:The Union Cycliste Internationale has deemed transgender female athlete’s ineligible for the female category due to concerns about performance advantages.We conducted a follow-up analysis on laboratorybased performance indicators of sports performance using data from a longitudinally assessed transgender woman athlete undergoing gender-affrming hormone therapy(GAHT).Methods:We evaluated laboratory performance indicators in transgender and cisgender women athletes using dualenergy X-ray absorptiometry scanning,handgrip strength measurement,jump testing,and cardiopulmonary exercise.Additionally,we assessed a transgender sub-elite cyclist before and after undergoing GAHT.Results:After one year of GAHT,the transgender athlete showed declines in handgrip strength(7–13%),countermovement jump(23–29%),and V̇O_(2)max(15–30%).After 3 months,several performance indicators(absolute handgrip,peak power,relative peak power,average power,relative average power,V̇O2max and relative V̇O_(2)max)were above the mean of cisgender female athletes,while others(Relative handgrip,countermovement jump and relative countermovement jump)were below.Similar trends were observed at 6 months and 1 year.Summary:This hypothetical analysis,although with limited evidence,suggests the transgender athlete could compete equitably in elite cycling events within the female category after one year of GAHT.Adjustments based on competition data would ensure fairness.Further analysis after an additional 12 months is recommended to assess the impact of 2 years of GAHT.An outright ineligibility for the female category for transgender women athletes would hinder a true assessment of performance fairness.
文摘Background: The degree to which one identifies as male or female has a profound impact on one’s life. Yet, there is a limited understanding of what contributes to this important characteristic termed gender identity. In order to reveal factors influencing gender identity, studies have focused on people who report strong feelings of being the opposite sex, such as male-to-female (MTF) transsexuals. Method: To investigate potential neuroanatomical variations associated with transsexualism, we compared the regional thickness of the cerebral cortex between 24 MTF transsexuals who had not yet been treated with cross-sex hormones and 24 age-matched control males. Results: Results revealed thicker cortices in MTF transsexuals, both within regions of the left hemisphere (i.e., frontal and orbito-frontal cortex, central sulcus, perisylvian regions, paracentral gyrus) and right hemisphere (i.e., pre-/post-central gyrus, parietal cortex, temporal cortex, precuneus, fusiform, lingual, and orbito-frontal gyrus). Conclusion: These findings provide further evidence that brain anatomy is associated with gender identity, where measures in MTF transsexuals appear to be shifted away from gender-congruent men.
文摘Transgender people sometimes use cross-sex hormones without medical supervision. The use of cross-sex hormones, as well as the functional health and mental well-being, among male-to-female transgendered people （＇kathoeys＇） in Chiang Mai, Thailand, was studied. Sixty kathoeys were interviewed regarding their use of cross-sex hormones and their familyrelationships. Individuals also completed the Life Orientation Test Revised （LOT-R） to assess dispositional optimism, the Social Functioning Questionnaire （SFQ） and the Short Form Health Survey 36 （SF-36）. Three categories were established as follows： those who never cross-dress, those who sometimes cross-dress and those who always cross-dress in public. Of the 60 subjects, 44 had used hormones for prolonged periods （9.7＋6.1 years）. Their use was related to the permanence of cross-dressing but unrelated to functional health and mental well-being. Fifty percent of subjects had overdosed on commonly used oral contraceptives. Three people used injectable oestrogen in a higher-than-recommended dose. Self-acceptance was high or reasonably good （83%） compared to no acceptance （17%）, and neither was related to the permanence of cross-dressing. Their acceptance by parents and siblings was also relatively high （85% and 89%, respectively）. The permanence of cross-dressing had no effect on the scores of optimism, SF-36 scores and social functioning. Acceptance by oneself or one＇s parents did not seem to affect most aspects of functional health and mental well-being, but non-acceptance by siblings generated lower scores on the social functioning and general mental health subscales. Stressors tended to include physical rather than social factors. In conclusion, the unsupervised use of cross-sex hormones was common among kathoeys, and 50% of the sample had overdosed on them. Acceptance was relatively good, except by siblings. New strategies are needed for a more responsible use of cross-sex hormones.
文摘Transgender(trans)Filipinos are disproportionately vulnerable to health problems because of the inaccessibility of essential healthcare services resulting from the invisibility and exclusion of trans health in Philippine health and related social institutions.Because of the institutional prejudice and discrimination against trans Filipinos in Philippine society,an intersectional approach presents an opportunity to analyze the invisibility and potentially elucidate the unique health needs of trans Filipinos.This article elucidates how the invisibility of trans Filipinos in health is a product of co-existing and interacting prejudiced and discriminatory institutions,such as the law,education,and medicine,where the historical experiences of colonization,the hegemony of cisgenderism,and the impact of capitalism remain salient.By elucidating these co-existing and interacting structures and forces,this article highlights the gaps in the Philippine healthcare system,such as the lack of affirming and protective policies for trans health and the limited cul-tural competence of healthcare providers.In light of these,future research and policy work must work towards inte-grating gender-specific and gender-inclusive approaches,centering the voices of trans Filipinos in health discourses,and decolonizing and expanding the local understanding of trans health among Filipinos.
基金Supported by Australian Government National Health and Medical Research Council,No.APP1143333Endocrine Society of Australia+2 种基金Austin Medical Research FoundationViertel Charitable Foundation Clinical Investigator Award,No.VIERCI2017009Royal Australasian College of Physicians Vincent Fairfax Family Foundation
文摘BACKGROUND Transgender individuals receiving masculinising or feminising gender-affirming hormone therapy with testosterone or estradiol respectively,are at increased risk of adverse cardiovascular outcomes,including myocardial infarction and stroke.This may be related to the effects of testosterone or estradiol therapy on body composition,fat distribution,and insulin resistance but the effect of genderaffirming hormone therapy on these cardiovascular risk factors has not been extensively examined.AIM To evaluate the impact of gender-affirming hormone therapy on body composition and insulin resistance in transgender individuals,to guide clinicians in minimising cardiovascular risk.METHODS We performed a review of the literature based on PRISMA guidelines.MEDLINE,Embase and PsycINFO databases were searched for studies examining body composition,insulin resistance or body fat distribution in transgender individuals aged over 18 years on established gender-affirming hormone therapy.Studies were selected for full-text analysis if they investigated transgender individuals on any type of gender-affirming hormone therapy and reported effects on lean mass,fat mass or insulin resistance.RESULTS The search strategy identified 221 studies.After exclusion of studies that did not meet inclusion criteria,26 were included(2 cross-sectional,21 prospectiveuncontrolled and 3 prospective-controlled).Evidence in transgender men suggests that testosterone therapy increases lean mass,decreases fat mass and has no impact on insulin resistance.Evidence in transgender women suggests that feminising hormone therapy(estradiol,with or without anti-androgen agents)decreases lean mass,increases fat mass,and may worsen insulin resistance.Changes to body composition were consistent across almost all studies:Transgender men on testosterone gained lean mass and lost fat mass,and transgender women on oestrogen experienced the reverse.No study directly contradicted these trends,though several small studies of short duration reported no changes.Resu
文摘Objective: The main objective of this study is to evaluate the prevalence of HIV infection among the clients attending ICTC, Gauhati Medical College & Hospital, Guwahati, for a period of seven years, i.e., from April 2008 to March 2015. Material & Method: A total of 40,983 clients attended ICTC, Gauhati Medical College & Hospital from the year 2008 to 2015. Serum samples were collected after taking informed consent and pre-test counseling. In India for all ICTCs, NACO (National AIDS Control Organization), a national guidelines has been followed for HIV testing, reporting and release of results with post test counseling. Results: Of the total 40,983 clients tested for HIV infection, 1919 (4.68%) were found to be HIV seropositive. Seropositivity was higher in male clients i.e. 1314 (68.47%) than female i.e. 604 (31.47%) followed by transgender (TG), i.e., 1 (0.0005%). Heterosexual route of transmission was the major route seen in 1666 clients (86.81%). Maximum HIV seropositivity was in the age group of 45 - 49 years (43.62%). Conclusion: HIV prevalence of 4.68 % among the clients attending ICTC, Gauhati Medical College & Hospital, Guwahati, puts the spotlight on the HIV burden in this part of the country and suggests the need for the scaling up of focused prevention efforts in high-risk groups.
文摘Objective: The purpose of this study is to estimate the prevalence of HIV infection among the clients attending ICTC, LHMC of New Delhi, for a period of five years, i.e., from 2008 to 2012. Material & Method: A total of 25,413 clients attended ICTC, LHMC from the year 2008 to 2012. Serum samples were collected after taking informed consent and pre-test counseling. In India for all ICTCs, NACO (National AIDS Control Organization), a national guidelines has been followed for HIV testing, reporting and release of results with post test counseling. Results: Out of the total 25,413 clients tested for HIV infection, 963 (3.78%) were found to be HIV-1 seropositive. Seropositivity was higher in male clients i.e. 625 (64.4%) than female i.e. 336 (34.8%) followed by transgender (TG), i.e., 2 (0.2%). Heterosexual route of transmission was the major route seen in 676 clients (70.1%). Maximum HIV seropositivity was in the age group of 25 - 34 years (35.4%). No HIV-2 case was found among the studied population. Conclusion: HIV prevalence of 3.78% among the clients attending ICTC, LHMC, New Delhi, puts light on the burden on HIV in this part of the country and suggests the need for the scaling up of focused prevention efforts in high-risk groups.
文摘In comparison to the arduous process of rights advocacy in Hong Kong, transsexuals in China＇s mainland achieved their right to marry via some ＂silent changes＂ there was no legal activism from transsexual communities, no debates or hearings in the legislature, and no landmark judgments made by the judiciary. From a perspective of comparative law, transsexuals＇ right It endeavors to dis this article attempts to analyze the legal changes regarding to marry in China＇s mainland in light of the struggles in Hong Kong. cuss to what extent the seemingly ＂smooth＂ and ＂unintended＂ way of opening up marriage to transsexuals in China＇s mainland could be beneficial to trans rights and equality in general.
