Association between sexual violence and HIV among sexual and gender minorities in low-resource settings: A meta-analysis.
Hong Chen, Yunlan Jiang, Le Li et al.
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In 30 seconds
This systematic review and meta-analysis pooled observational evidence on sexual violence and HIV infection among sexual and gender minorities in low-resource settings. Across 21 studies, sexual violence was associated with higher odds of HIV infection (pooled OR = 2.05, 95% CI: 1.71-2.47; I 2 = 57.4%). The association was stronger among transgender women than cisgender men who have sex with men. Evidence was concentrated in these groups, with only one small study of women who have sex with women, limiting generalisability to that population.
Key findings
- Sexual violence was associated with higher odds of HIV infection (pooled OR = 2.05, 95% CI: 1.71-2.47; I 2 = 57.4%).
- The observed association was stronger among transgender women (OR = 3.14) than cisgender men who have sex with men (OR = 1.84).
- After trim-and-fill adjustment for detected publication bias, the pooled OR was 1.73.
- Only one small-sample study included women who have sex with women.
Why it matters
The findings highlight an overlap between sexual violence and HIV burden in the populations represented, and suggest that the observed association may differ by gender identity. This supports attention to violence and HIV together in research and service planning, while recognising that the pooled association does not establish causation and that evidence is sparse for women who have sex with women.
What to keep in mind
The evidence came from observational studies, significant publication bias was detected, and findings were predominantly based on transgender women and cisgender men who have sex with men; only one small study included women who have sex with women.