Silicones, hormones and HIV in transgender street prostitutes

Transgender street prostitutes (TSP; transvestites and transsexuals) are at high risk of HIV infection. This is mainly through anal sex or the injecting of hard drugs but possibly also by injecting hormones or silicones. Therefore, TSP could play an important role in HIV transmission, by forming an epidemiological `bridge' between homosexual men, injecting drug users (IDU) and the heterosexual population. We report on the risk of HIV infection in a group of TSP in the Netherlands, and their potential for acting as a link for spread from high-risk groups to the heterosexual population.