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Sexual violence is associated with increased odds of HIV infection among sexual and gender minoritiesSexual Violence Linked to Higher Risk of HIV Infection

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Key Takeaway
Recognize that sexual violence is associated with increased odds of HIV infection in sexual and gender minorities.

This meta-analysis synthesized 21 observational studies to evaluate the relationship between sexual violence and HIV infection among sexual and gender minorities in low-resource settings. The analysis focused on transgender women and cis-gender men who have sex with men (MSM) to identify disparities and the impact of gender identity on infection risks.

The meta-analysis found a significant association between sexual violence and HIV infection with an OR of 2.05 (95% CI: 1.71-2.47). Specifically, transgender women showed a stronger association with increased odds of HIV infection (OR = 3.14) compared to cis-gender MSM (OR = 1.84). When adjusted for publication bias using trim-and-fill, the pooled OR was 1.73.

Several limitations were noted, including significant publication bias and a lack of sufficient evidence regarding women who have sex with women (WSW). Because the underlying data are from observational studies, these results indicate an association rather than a direct cause. These findings suggest a need for trauma-informed multi-level strategies to address sexual violence and HIV-related health disparities in these populations.

A review of 21 observational studies looked at the link between sexual violence and HIV infection. The study focused on sexual and gender minorities, including transgender women and cis-gender men who have sex with men, living in low-resource settings. The researchers found that sexual violence is associated with a higher risk of HIV infection.

Specifically, the data showed a stronger link for transgender women compared to cis-gender men who have sex with men. While the study found a clear connection between violence and HIV, it is important to note that these are observational results. This means the study shows a link rather than proving that one thing caused the other.

There was limited information available for women who have sex with women in this specific review. Because of these limitations and the nature of the data, the findings are not intended to provide a specific medical plan. Instead, the results highlight the need for better support and trauma-informed care for those affected by violence.

What this means for you:
Research shows a link between sexual violence and higher HIV risk, especially for transgender women.

Common questions

Who was included in this study?

The study included 21 observational studies focusing on sexual and gender minorities in low-resource settings. This group included transgender women and cis-gender men who have sex with men. The findings were most specific to these groups, while there was limited evidence available for women who have sex with women.

What did the study find about the link between violence and HIV?

The review found a significant association between sexual violence and the odds of HIV infection. Specifically, the data showed a stronger association for transgender women compared to cis-gender men who have sex with men. These results indicate a clear link between the experiences of violence and HIV risk.

How certain are these results?

Because these results come from observational studies, they show a link rather than a direct cause. Additionally, the review noted some publication bias and limited data for certain groups. You should speak with a healthcare provider to discuss how these findings relate to specific health needs.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
OBJECTIVES: Sexual violence has been reported to correlate with HIV infection among Sexual and gender minorities, yet evidence regarding the association between sexual violence and HIV infection within this population in low-resource settings remains limited. This meta-analysis aimed to quantify the pooled association and explore subgroup disparities. STUDY DESIGN: Systematic review and meta-analysis of observational studies following PRISMA 2020. METHODS: Registered on PROSPERO (CRD420261398499). We searched eight databases up to April 7, 2026. Random-effects models were used to pool odds ratios; subgroup analyses, univariate meta-regression, sensitivity analyses, trim-and-fill, Egger's and Begg's tests were performed. The AHRQ/NOS tool was applied to assess study quality. RESULTS: A total of 21 eligible observational studies were included. Only one small-sample study enrolled women who have sex with women (WSW), and the majority of evidence came from transgender women (TW) and cis-gender men who have sex with men (MSM).Sexual violence was significantly associated with elevated odds of HIV infection (pooled OR = 2.05, 95% CI: 1.71-2.47, I = 57.4%). The magnitude of this observed association was stronger among TW (OR = 3.14) compared with cisgender MSM (OR = 1.84). Univariate meta-regression identified gender identity as the primary detectable source of between-study heterogeneity. Significant publication bias was detected; the trim-and-fill adjusted pooled OR was 1.73. CONCLUSIONS: We observed a significant association between sexual violence and elevated odds of HIV infection among Sexual and gender minorities in low-resource contexts, with TW showing the strongest association. These findings underscore the need for trauma-informed multi-level strategies targeting sexual violence and HIV-related health disparities in this population. Notably, evidence was predominantly generated from TW and cis-MSM, with only one small study among WSW; our findings cannot be generalized to WSW.
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