Exploring sexual health and risk of sexually transmitted infections among gender diverse individuals

Introduction: Transgender, non-binary, gender non-conforming, and other gender diverse individuals (TGN) may be at higher risk of sexually transmitted infections (STIs). Transgender women specifically bear a disproportionate burden of HIV and other STIs worldwide. This study describes STI knowledge, risks, and prevention practices among TGN to better characterize barriers to sexual health care and identify potential platforms for sexual health education focusing on STI prevention. Materials and Methods: Qualitative interviews were conducted with N = 14 TGN individuals until thematic saturation was reached. Transcripts were coded and analyzed using thematic analysis. Results: Four major themes emerged: (1) Sexual risk behaviors and STI prevention practices varied across participants; (2) individuals who demonstrated more knowledge about STIs either had a significant identifiable sexual educational experience or had a past personal experience with an STI; (3) individuals were interested in receiving information about STIs and sexual health from health care providers, school sexual education programs, and online resources based on a desire for accessible, private, factual, and inclusive content; and (4) public messaging around sexual health and STIs was seen both as potentially stigmatizing, but also important for increasing awareness of available services. Discussion: We found that while important, considering gender alone may not adequately characterize risk of STI infection for TGN populations, and more research is needed to better characterize risk profiles. Individuals were interested in learning about sexual health and STI prevention from school curricula, health care settings, online resources, and public messaging advertisements, and had recommendations to ensure that these forms of information sharing were relevant, inclusive, and non-stigmatizing.