Abstract
The epidemiology of human T-lymphotropic virus (HTLV) among sexual minority cisgender women (SMCW) remains poorly understood globally. We conducted a cross-sectional study of 251 SMCW in Belém, Brazilian Amazon, between March 2023 and April 2025. Participants underwent serological screening (ELISA) with molecular confirmation (qPCR). The prevalence of HTLV infection was 0.4% (1/251), with HTLV-2 identified in a 46-year-old asymptomatic bisexual woman with previous male partners and a current female partner. Serological testing showed strong ELISA reactivity (OD ratio 3.8), and qPCR confirmed HTLV-2 with a Ct value of 28.4 for the pol gene, while HTLV-1 remained negative. This represents the first documented HTLV-2 case in SMCW in the Amazon region, demonstrating viral circulation in an understudied population. Despite the low prevalence, comparable to the general population, these findings highlight the need for inclusive epidemiological surveillance and culturally sensitive prevention strategies for LGBTQIA+ communities in endemic regions.
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