Factors Associated with the Persistence of High-Risk Behaviors in Trans Women in Paraguay, 2020 to 2023
Abstract
Introduction: Trans women continue to be one of the most vulnerable populations to HIV in Paraguay, due to multiple individual, social, and structural factors that determine the persistence of high-risk sexual behaviors. Despite prevention efforts, significant gaps persist that impede an effective and inclusive response. Objective: To analyze the factors associated with the persistence of high-risk behaviors for HIV infection in trans women in Paraguay during the period 2020 to 2023. Methodology: An observational, analytical, retrospective cohort study with a quantitative approach. One hundred and fifty-four trans women participated in two measurements (2020 and 2023) in the regions of Asunción, Central, and Alto Paraná. The persistence of risk behaviors was analyzed, defined as the continuation of at least one practice (unprotected anal sex, sex work, or drug use). Descriptive and bivariate analyses were performed. The significance level was set at p < 0.05. Results: The persistence of risk behaviors was 61.04%. Significant associations were observed with age (greater persistence between 20 and 39 years of age), department of residence (higher in Alto Paraná), and the presence of depressive symptoms (p = 0.002). No significant differences were found regarding educational level, HIV knowledge, or risk perception. Conclusion: The persistence of risk behaviors in trans women is influenced by structural, territorial, and mental health factors. Current prevention strategies should be strengthened through an intersectoral, territorially sensitive approach with a strong component in mental health and social inclusion.
Keywords:
Risk behaviors, HIV, Transgender, ParaguayDownloads
References
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Copyright (c) 2026 Gloria Aguilar, Liliana Gimenez, Carlos Miguel Rios-González, Maria Isabel Rodriguez-Riveros, Elena María Candia Florentín
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