{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T15:00:25Z","timestamp":1776956425913,"version":"3.51.4"},"reference-count":43,"publisher":"BMJ","issue":"8","funder":[{"name":"PEPFAR\/USAID"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,5,18]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine factors associated with HIV infection among transgender women in Cambodia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>HIV high-burden sites including the capital city and 12 provinces.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>This study included 1375 sexually active transgender women with a mean age of 25.9 years (SD 7.1), recruited by using respondent-driven sampling for structured questionnaire interviews and rapid finger-prick HIV testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>HIV infection detected by using Determine antibody test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HIV prevalence among this population was 5.9%. After adjustment for other covariates, participants living in urban areas were twice as likely to be HIV infected as those living in rural areas. Participants with primary education were 1.7 times as likely to be infected compared with those with high school education. HIV infection increased with age; compared with those aged 18\u201324 years, the odds of being HIV infected were twice as high among transgender women aged 25\u201334 years and 2.8 times higher among those aged \u226535 years. Self-injection of gender affirming hormones was associated with a fourfold increase in the odds of HIV infection. A history of genital sores over the previous 12 months increased the odds of HIV infection by threefold. Transgender women with stronger feminine identity, dressing as a woman all the time, were twice as likely to be HIV infected compared with those who did not dress as a woman all the time. Having never used online services developed for transgender women in the past six\u2009months was also associated with higher odds of being HIV infected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Transgender women in Cambodia are at high risk of HIV. To achieve the goal of eliminating HIV in Cambodia, effective combination prevention strategies addressing the above risk factors among transgender women should be strengthened.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-015390","type":"journal-article","created":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T20:25:24Z","timestamp":1502483124000},"page":"e015390","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["HIV prevalence and factors associated with HIV infection among transgender women in Cambodia: results from a national Integrated Biological and Behavioral Survey"],"prefix":"10.1136","volume":"7","author":[{"given":"Srean","family":"Chhim","sequence":"first","affiliation":[{"name":"FHI 360, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chanrith","family":"Ngin","sequence":"additional","affiliation":[{"name":"KHANA Center for Population Health Research, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pheak","family":"Chhoun","sequence":"additional","affiliation":[{"name":"KHANA Center for Population Health Research, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sovannary","family":"Tuot","sequence":"additional","affiliation":[{"name":"KHANA Center for Population Health Research, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheaty","family":"Ly","sequence":"additional","affiliation":[{"name":"Population Services Khmer (PSK), Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phalkun","family":"Mun","sequence":"additional","affiliation":[{"name":"National Center for HIV\/AIDS, Dermatology and STD (NCHADS), Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khondyla","family":"Pal","sequence":"additional","affiliation":[{"name":"KHANA Center for Population Health Research, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Macom","sequence":"additional","affiliation":[{"name":"Asia Pacific Regional Office, FHI 360, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Philippe","family":"Dousset","sequence":"additional","affiliation":[{"name":"FHI 360, Phnom Penh, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gitau","family":"Mburu","sequence":"additional","affiliation":[{"name":"Division of Health Research, Lancaster University, Lancaster, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3045-5386","authenticated-orcid":false,"given":"Siyan","family":"Yi","sequence":"additional","affiliation":[{"name":"KHANA Center for Population Health Research, Phnom Penh, Cambodia"},{"name":"Center for Global Health Research, Touro University California, Vallejo, CA, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,8,11]]},"reference":[{"key":"2025121604530236000_7.8.e015390.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70315-8"},{"key":"2025121604530236000_7.8.e015390.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-011-0053-5"},{"key":"2025121604530236000_7.8.e015390.3","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1007\/s10461-010-9850-5","article-title":"HIV prevalence, risk behavior, hormone use and surgical history among transgender persons in Thailand","volume":"15","author":"Guadamuz","year":"2011","journal-title":"AIDS Behav"},{"key":"2025121604530236000_7.8.e015390.4","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300433"},{"key":"2025121604530236000_7.8.e015390.5","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.7.1193"},{"key":"2025121604530236000_7.8.e015390.6","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.91.6.915"},{"key":"2025121604530236000_7.8.e015390.7","unstructured":"Gay and Lesbian Medical Association. 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