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The aim of this study was to assess sexual behaviors and vulnerability of transgender women to STIs including HIV.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>A cross-sectional study was conducted using convenient sampling from August 2019 to March 2020 in Iran at \u201cSupport center for Iranian transgender\u201d and \u201cShiraz Forensic Medicine\u201d where transgender individuals refer to follow the steps of gender affirmation. 127 transgender women participated in this study. A researcher-made questionnaire was applied for evaluating sexual behaviors, STIs and HIV.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The mean age of participants and their age of sexual debut were 27.6 and 16.9, respectively. 92.1% of participants were single with experience of sex and 59.3% had one sex partner in the last 2\u00a0years. 96.9% of the participants were heterosexual with 67.2% reporting experiencing orgasm in at least 50% of their sexual intercourse. However, 42.5% reported sexual pain and the same percentage reported low or very low sexual satisfaction. About half of the participants used condoms occasionally during sex (48.7%) and the most important reason for not using condoms in most cases was not having a condom (37.9%). Some of participants had little knowledge of the symptoms (33.9%) and complications (44.1%) of STIs. Although 87.4% and 72.4% of participants had never been tested for a STI and HIV, 1.6% were HIV positive and 18.1% had a history of STIs. Also, 26% of people had undergone vaginoplasty and a significant association was observed between vaginoplasty with sexual satisfaction (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090. 01(.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Some of transgender women in this study were involved in high-risk sexual behaviors while unaware of the signs and symptoms of STIs. Also, despite reaching orgasm in most of their sexual relationships, they had little sexual satisfaction that could probably be related to body dissatisfaction, and lack of vaginoplasty in the majority of them. The need for gender affirming surgeries and psychiatric interventions affecting body satisfaction was identified in this group.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12905-022-01753-7","type":"journal-article","created":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T09:07:05Z","timestamp":1652519225000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Sexual behaviors and vulnerability to sexually transmitted infections among transgender women in Iran"],"prefix":"10.1186","volume":"22","author":[{"given":"Azar","family":"Nematollahi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safoora","family":"Gharibzadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Damghanian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeid","family":"Gholamzadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farnaz","family":"Farnam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,14]]},"reference":[{"issue":"8","key":"1753_CR1","first-page":"32","volume":"49","author":"AP Association","year":"2018","unstructured":"Association AP. 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To maintain confidentiality and privacy, participants were assured that their information was confidential and their names or addresses will not be disclosed in the research. Written consent was obtained from all participants and were given to them a gift of 250,000 Rials )equivalent to one $ US( for participating in the study. This study was reviewed and approved by the Ethics Committee of Tehran University of Medical Sciences. All methods were performed in accordance with the relevant guidelines and regulations of the Research Ethics Committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"170"}}