Assessment of targeted intervention programs on STI symptoms among Hijra and transgender in India: analysis of national level integrated biological and behavioral surveillance

We aimed to evaluate the effectiveness of a Targeted Intervention (TI) program on Sexually Transmitted Infection (STI) symptoms among Hijra and Transgender (H/TG) persons in India. We analyzed the H/TG data from the national Integrated Biological and Behavioral Surveillance (IBBS) Survey for the years 2014-2015. The IBBS was a cross-sectional survey of 4,966 H/TG. Descriptive analysis was employed to delineate the socio-demographic profile of H/TG, along with program exposure components. Bivariate and multivariate logistic regression were utilized to compute unadjusted and adjusted odds ratios, along with their 95% confidence intervals. The Propensity Score Matching (PSM) method was employed to evaluate the effectiveness of the TI program on STI symptoms. All statistical analyses were performed using STATA version 16.0 (STATA Corp., College Station, TX, USA). H/TG who had received information on STI/HIV/AIDS from Peer Educators/Outreach Workers (PEs/ORWs) were 3.03 times more likely to have STI symptoms (aOR: 3.03, CI: 2.44-3.76), than the H/TG who did not receive the information. H/TG who had received condoms from PEs/ORWs were 0.57 times less likely to report STI symptoms (aOR: 0.57, CI: 0.47-0.71) than the H/TG who did not receive the condom. H/TG who had seen a demonstration on correct use of condom from PEs/ORWs were 0.67 times less likely to report STI symptoms (aOR: 0.67, CI: 0.57-0.80) than the H/TG who had not seen the demonstration. The TI program intervention among H/TG was effective in reducing the reported prevalence of STI symptoms.