Prevalence of HTLV-1 and HTLV-2 infection among transgender women in Brazil: A multicenter study

Transgender Women and Travestis (TWT) are at increased risk for sexually transmitted infections due to contexts of vulnerability related to socioeconomic and behavioral factors. However, data on the prevalence of Human T-lymphotropic viruses type 1 and 2 (HTLV-1/2) in this population remain scarce. This study aimed to investigate the seroprevalence of HTLV-1/2 infection among TWT in five Brazilian capitals.

A cross-sectional study was conducted from 2019 to 2021 in five Brazilian capital cities, representing all geographic regions of the country. A total of 1,269 blood samples were tested for HTLV-1/2 antibodies using ELISA and Western Blot assays. Sociodemographic and behavioral data were obtained through structured interviews. Among 1,269 samples, most participants identifying as transgender women (59.18%) or travestis (29.79%) with a median age of 30 years. A total of 12 samples tested positive for anti-HTLV-1/2 (0.94%; CI 95%: 0.53-1.65), with positive cases in Manaus (n = 4, 1.50%), Salvador (n = 4, 2.22%), and Porto Alegre (n = 4, 2.12%), and none in São Paulo or Campo Grande. Associated behaviors included inconsistent condom use and a history of HIV and syphilis.

Our study highlights the presence of HTLV-1/2 infection among TWT in Brazil, with regional differences. These findings underscore the need for targeted public health interventions, including increased screening, health education, and access to healthcare services, to address the specific vulnerabilities of this population.