RESUMO Objective Determinar a aceitabilidade e os fatores associados à realização do exame físico para detecção de infecções sexualmente transmissíveis (IST) sintomáticas em mulheres trans e travestis no Brasil. Métodos: Foram utilizados dados do “TransOdara”, estudo transversal de prevalência de IST, realizado em cinco capitais brasileiras (Campo Grande, Manaus, Porto Alegre, Salvador e São Paulo) entre dezembro de 2019 e julho de 2021. As 1.317 mulheres trans e travestis, com idade ≥18 anos, recrutadas por meio do método respondent-driven sampling passaram por entrevistas e responderam a um questionário estruturado. Foi ofertada consulta médica, incluindo realização de exame físico e coleta de amostras de vários locais para detectar diversas IST. Para a análise dos fatores associados à aceitabilidade do exame físico (geral, genital e anorretal), considerou-se as características sociodemográficas das participantes que permitiram a sua realização. Resultados: A maioria (65,4%; intervalo de confiança – IC95% 62,7–68,0) concedeu permissão para o exame geral (incluindo orofaríngeo), com permissão concedida em menor proporção para os exames genitais (42,3%; IC95% 39,6–46,0) ou anorretais (42,1%; IC95% 39,4–44,9). No geral, 34,4% (IC95% 31,8–37,0) delas recusaram todos os exames. As participantes com sintomas de IST foram significativamente mais propensas a conceder permissão para o exame completo do que as participantes assintomáticas (64,3 vs 37,4%, odds ratio ajustado – AOR=3,6, IC95% 2,4–5,5). Os fatores significativamente associados à aceitabilidade do exame completo na análise multivariada incluíram idade (AOR=1,5 para ≥25 anos), religião (AOR=2,0 para afro-brasileiras, AOR=1,9 para outras religiões em comparação com nenhuma religião) e nível de escolaridade (AOR=2,0 para nível superior). Conclusão: No contexto do manejo de IST, nós observamos aceitação limitada de exames anogenitais entre mulheres trans e travestis, com maior aceitação entre aquelas com sintomas de IST. (IST Brasil Métodos TransOdara, TransOdara , “TransOdara” Campo Grande Manaus Alegre Paulo 201 2021 1317 1 317 1.31 18 ≥1 anos respondentdriven respondent driven estruturado médica (geral anorretal, anorretal anorretal) considerouse considerou se Resultados 65,4% 654 65 4 (65,4% IC95 IC 62,7–68,0 627680 62 7 68 0 orofaríngeo, orofaríngeo orofaríngeo) 42,3% 423 42 3 (42,3% 39,6–46,0 396460 39 6 46 42,1% 421 (42,1% 39,4–44,9. 394449 39,4–44,9 . 44 9 39,4–44,9) 344 34 34,4 (IC95 31,8–37,0 318370 31 8 37 64,3 643 64 (64, 374 37,4% AOR36 AOR AOR=3,6 2,4–5,5. 2455 2,4–5,5 2 5 2,4–5,5) AOR=1,5 AOR15 (AOR=1, 25 ≥2 anos) AOR=2,0 AOR20 (AOR=2, afrobrasileiras, afrobrasileiras afro brasileiras, afro-brasileiras AOR19 AOR=1, superior. superior superior) Conclusão “TransOdara 20 202 131 1.3 ≥ 65,4 (65,4 IC9 62,7–68, 62768 42,3 (42,3 39,6–46, 39646 42,1 (42,1 39444 39,4–44, 34, (IC9 31,8–37, 31837 64, (64 37,4 AOR3 AOR=3, 245 2,4–5, AOR1 (AOR=1 AOR=2, AOR2 (AOR=2 AOR=1 13 1. 65, (65, 62,7–68 6276 42, (42, 39,6–46 3964 3944 39,4–44 (IC 31,8–37 3183 (6 37, AOR=3 24 2,4–5 (AOR= AOR=2 AOR= (65 62,7–6 627 (42 39,6–4 396 394 39,4–4 31,8–3 318 ( 2,4– (AOR 62,7– (4 39,6– 39,4– 31,8– 2,4 62,7 39,6 39,4 31,8 2, 62, 39, 31,
ABSTRACT Objective This study aimed to determine the acceptability and factors associated with uptake of a physical examination for the detection of symptomatic sexually transmitted infections (STIs) by transgender women and travestis in Brazil. Methods: TransOdara was a multi-centric, cross-sectional STI prevalence study conducted among transgender women and travestis in five capital cities (Campo Grande, Manaus, Porto Alegre, Salvador and São Paulo) representing all Brazilian regions, between December 2019 and July 2021. A total of 1,317 self-identified transgender women and travestis aged ≥18 years were recruited using respondent-driven sampling and responded to a standard questionnaire. A medical consultation was offered including a physical examination and collection of samples from multiple sites to detect various STIs. Factors associated with uptake were investigated by reviewing demographic characteristics of participants who gave permission for physical examination (general, genital, and anorectal). Results: Most participants (65.4%, 95% confidence interval — 95%CI 62.7–68.0) gave permission for a general examination (including oropharyngeal), with fewer permitting genital (42.3%, 95%CI 39.6–46.0) or anorectal (42.1%, 95%CI 39.4–44.9) examinations. Overall, 34.4% (95%CI 31.8–37.0) of participants refused all examinations. Participants with STI symptoms were significantly more likely to give permission for full examination than asymptomatic participants (64.3 vs. 37.4%, adjusted odds ratio — AOR=3.6, 95%CI 2.4–5.5). Other factors significantly associated with uptake of a full examination in multivariate analysis included age (AOR=1.5 for ≥25 years), religion (AOR=1.7 for Afro-Brazilian, AOR=1.9 for other religions compared to no religion), and education (AOR=2.0 for higher-level). Conclusion: In the context of STI management, this study found limited acceptance of anogenital examinations among transgender women and travestis, with higher acceptance among those with STI symptoms. STIs (STIs Brazil Methods multicentric, multicentric multi centric, centric multi-centric crosssectional cross sectional Campo Grande Manaus Alegre Paulo regions 201 2021 1317 1 317 1,31 selfidentified self identified 18 ≥1 respondentdriven respondent driven questionnaire general, (general anorectal. . anorectal) Results 65.4%, 654 65 4 (65.4% 95 95CI CI 62.7–68.0 627680 62 7 68 0 oropharyngeal, oropharyngeal , oropharyngeal) 42.3%, 423 42 3 (42.3% 39.6–46.0 396460 39 6 46 42.1%, 421 (42.1% 39.4–44.9 394449 44 9 Overall 344 34 34.4 31.8–37.0 318370 31 8 37 64.3 643 64 (64. vs 374 37.4% AOR36 AOR AOR=3.6 2.4–5.5. 2455 2.4–5.5 2 5 2.4–5.5) AOR=1.5 AOR15 (AOR=1. 25 ≥2 years, years) AOR=1.7 AOR17 AfroBrazilian, AfroBrazilian Afro Brazilian, Afro-Brazilian AOR19 AOR=1. religion, religion) AOR=2.0 AOR20 (AOR=2. higherlevel. higherlevel level higher-level) Conclusion management 20 202 131 1,3 ≥ 65.4% (65.4 62.7–68. 62768 42.3% (42.3 39.6–46. 39646 42.1% (42.1 39.4–44. 39444 34. 31.8–37. 31837 64. (64 37.4 AOR3 AOR=3. 245 2.4–5. AOR1 (AOR=1 AOR=1 AOR=2. AOR2 (AOR=2 higher-level 13 1, 65.4 (65. 62.7–68 6276 42.3 (42. 39.6–46 3964 42.1 39.4–44 3944 31.8–37 3183 (6 37. AOR=3 24 2.4–5 (AOR= AOR= AOR=2 65. (65 62.7–6 627 42. (42 39.6–4 396 39.4–4 394 31.8–3 318 ( 2.4– (AOR 62.7– (4 39.6– 39.4– 31.8– 2.4 62.7 39.6 39.4 31.8 2. 62. 39. 31.