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. 2024 Jul 17;11(8):ofae410.
doi: 10.1093/ofid/ofae410. eCollection 2024 Aug.

High Hepatitis B Prevalence and Vaccination Needs Among Transgender Women and Men Sex Workers in Barcelona, Spain

Adrián Antuori  1   2 , Anna Not  1   2 , Jocelyn Mesías-Gazmuri  3   4   5 , Victoria González  1   3   6 , Marcos Montoro-Fernandez  3 , Cinta Folch  3   4   6 , Verónica Saludes  1   6 , Marta Villar  7 , Mercè Meroño  8 , Sonia Paytubi  9   10 , Laia Alemany  9   10 , Jordi Casabona  3   4   5   6 , Elisa Martró  1   6 ; SexCohort Group
Collaborators, Affiliations

High Hepatitis B Prevalence and Vaccination Needs Among Transgender Women and Men Sex Workers in Barcelona, Spain

Adrián Antuori et al. Open Forum Infect Dis. .

Abstract

Background: Transgender women sex workers (TWSWs) and men sex workers (MSWs) are especially vulnerable to acquiring hepatitis B virus (HBV) infection. We aimed to describe HBV prevalence (hepatitis B surface antigen [HBsAg] and core antibody [HBcAb]) and associated risk factors for HBV exposure (HBcAb), to assess vaccination status and risk factors for no prior vaccination, and to compare HBV prevalence and vaccination status between TWSWs and MSWs.

Methods: The SexCohort study was advertised to TWSWs and MSWs through several communication channels. At cohort entry through 2 community-based organizations in Barcelona, the study population was screened for HBV and other sexually transmitted infections, and an epidemiological questionnaire was administered (n = 271).

Results: Overall, 93.0% of participants were migrants, mostly from South and Central American countries. HBsAg prevalence was 1.9% (TWSWs, 2.4%; vs MSWs, 0.9%; P = .42), and previous exposure to HBV was 31.8% (TWSWs, 38.5%; vs MSWs, 20.8%; P = .002). Over 5 years of sex work (adjusted odds ratio [aOR], 9.35), prior exposure to Treponema pallidum (aOR, 3.49), and treatment with anxiolytic drugs (aOR, 3.23) were associated with HBV exposure. Overall, 33.7% of participants exhibited immunity from vaccination (TWSWs, 30.8%; vs MSWs, 38.61%; P < .001), while 34.4% were candidates to HBV vaccination (TWSWs, 30.8%; vs MSWs, 40.6%; P < .001). Never having been on pre-exposure prophylaxis for HIV (odds ratio [OR], 4.23) and non-Spanish origin (OR, 5.00) were associated with no prior HBV vaccination.

Conclusions: There is a need to reinforce screening and vaccination programs aimed at TWSWs and MSWs as integrated services offered at the community centers commonly accessed by these populations.

Keywords: hepatitis B virus; men sex workers; risk factors; trans women sex workers; vaccination.

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Conflict of interest statement

Potential conflicts of interest. The authors have no relevant financial or nonfinancial interests to disclose related to this work.

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