Prevalence of HIV/AIDS among Transgender People in Three Big Cities of Punjab, Pakistan

Muhammad Abdul Rehman; Muhammad Bilal; . Abdullah; Muhammad Talaha Shoukat; Muhammad Haseeb Nawaz; Kashif Shabbir; Ans Haider; Mahad Yasin; Muhammad Noman

doi:10.54112/bcsrj.v7i5.2313

Authors

Muhammad Abdul Rehman Department of Pathology, Faculty of Medicine and Allied Health Sciences, The University of Faisalabad (TUF), Faisalabad, Punjab, Pakistan
Muhammad Bilal Department of Pathology, Faculty of Medicine and Allied Health Sciences, The University of Faisalabad (TUF), Faisalabad, Punjab, Pakistan
. Abdullah Department of Pathology, Faculty of Medicine and Allied Health Sciences, The University of Faisalabad (TUF), Faisalabad, Punjab, Pakistan
Muhammad Talaha Shoukat Department of Pathology, Faculty of Medicine and Allied Health Sciences, The University of Faisalabad (TUF), Faisalabad, Punjab, Pakistan
Muhammad Haseeb Nawaz Department of Pathology, Faculty of Medicine and Allied Health Sciences, The University of Faisalabad (TUF), Faisalabad, Punjab, Pakistan
Kashif Shabbir Department of Pathology, Faculty of Medicine and Allied Health Sciences, The University of Faisalabad (TUF), Faisalabad, Punjab, Pakistan
Ans Haider Department of Pathology, Faculty of Medicine and Allied Health Sciences, The University of Faisalabad (TUF), Faisalabad, Punjab, Pakistan
Mahad Yasin Department of Pathology, Faculty of Medicine and Allied Health Sciences, The University of Faisalabad (TUF), Faisalabad, Punjab, Pakistan
Muhammad Noman Department of Pathology, Faculty of Medicine and Allied Health Sciences, The University of Faisalabad (TUF), Faisalabad, Punjab, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v7i5.2313

Keywords:

HIV Infections; Transgender Persons; Cross-Sectional Studies

Abstract

HIV/AIDS remains a major public health concern among transgender populations due to the combined effects of social exclusion, stigma, limited healthcare access, unsafe sexual practices, and poor HIV testing coverage. In Pakistan, city-level evidence on HIV burden among transgender communities is still limited. Objective: To determine the prevalence of HIV/AIDS and assess related sociodemographic, behavioral, awareness, and healthcare-access factors among transgender individuals in Punjab, Pakistan. Methods: This descriptive cross-sectional study included 150 transgender participants from various cities in Punjab, Pakistan, from January 2025 to December 2025. Participants were recruited through healthcare facilities, HIV treatment centers, community outreach activities, and transgender support organizations using a non-probability convenience sampling technique. Data were collected through a structured questionnaire, available medical records, and HIV testing reports. Information was obtained regarding demographic characteristics, HIV awareness, sexual behavior, condom use, sex work, injectable drug use, needle sharing, healthcare access, discrimination, HIV testing history, and HIV test results. Data were analyzed using SPSS version 27. Categorical variables were presented as frequencies and percentages. Associations between HIV test result category and selected variables were assessed using Pearson's chi-square test, with p<0.05 considered statistically significant. Results: Among 150 transgender participants, the highest proportion was in the 35–44-year age group (41; 27.3%), followed by the 25–34-year age group (40; 26.7%). Gender identity included transgender women (41, 27.3%), Khawaja Sira (40, 26.7%), other gender identities (40, 26.7%), and transgender men (29, 19.3%). Overall, 117 (78.0%) participants had heard about HIV/AIDS, but only 46 (30.7%) knew that condom use can prevent HIV transmission. A history of sexual intercourse was reported by 131 (87.3%) participants, 51 (34.0%) had more than five sexual partners in the previous six months, 50 (33.3%) never used condoms, and 62 (41.3%) were involved in sex work. 29 (19.3%) participants reported injectable drug use and needle sharing by 15 (10.0%). Overall, 90 (60.0%) participants had ever been tested for HIV. HIV positivity was 33/150 (22.0%) in the full sample, 33/90 (36.7%) among ever-tested respondents, and 33/65 (50.8%) among those with known positive or negative results. Knowledge of HIV testing services (χ²=14.797, p=0.002), injectable drug use (χ²=12.125, p=0.007), HIV testing status (p<0.001), and time since last HIV test (p<0.001) were significantly associated with HIV test-result category. Conclusion: A considerable burden of HIV/AIDS was observed among transgender participants in Punjab, particularly among those with available HIV test results. Limited condom-related knowledge, inconsistent condom use, multiple sexual partners, sex work, injectable drug use, poor healthcare access, and discrimination indicate the need for transgender-friendly HIV prevention, confidential testing, harm-reduction services, and effective linkage to care.

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