Factors Associated with Antiretroviral Therapy Adherence Among Transgender Women Receiving HIV Medical Care in the United States

Mizuno, Yuko; Beer, Linda; Huang, Ping; Frazier, Emma L.

doi:10.1089/lgbt.2017.0003

Cited by 27 publications

(20 citation statements)

References 23 publications

(25 reference statements)

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“…A recent meta-analysis reported that 19.1% of transgender women worldwide are HIV-infected (Baral et al, 2013). While transgender women are estimated to have 48-times the odds of being infected with HIV compared to all adults (Baral et al, 2013), previous studies have reported low rates of HIV treatment engagement and poor health outcomes related to their HIV infection (Mizuno, Beer, Huang, & Frazier, 2017; Pitasi, Oraka, Clark, Town, & DiNenno, 2017; Santos et al, 2014; Wiewel, Torian, Merchant, Braunstein, & Shepard, 2016).…”

Section: Introductionmentioning

confidence: 99%

Burden of HIV among young transgender women: factors associated with HIV infection and HIV treatment engagement

et al. 2018

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Young transgender women (YTW) are disproportionately affected by HIV, however, little is known about the factors associated with HIV infection and treatment engagement. We examined correlates of HIV infection and the steps of the HIV treatment cascade, specifically, being aware of their HIV infection, linked to care, on ART, and adherent to ART. We analyzed the baseline data of Project LifeSkills, a randomized control trial of sexually active YTW recruited from Chicago, Illinois and Boston, Massachusetts. We conducted multivariable Poisson regressions to evaluate correlates of HIV infection and the steps of the HIV treatment cascade. Nearly a quarter (24.7%) of YTW were HIV-infected. Among HIV-infected YTW, 86.2% were aware of their HIV status, 72.3% were linked to care, 56.9% were on ART, and 46.2% were adherent to ART. HIV-infected YTW who avoided healthcare due to cost in the past 12 months had lower odds of being linked to care (OR=0.55, 95% CI=0.30, 0.99) compared to those who did not, and HIV-infected YTW who do not have a primary care provider had lower odds of being on ART (OR=0.11, 95% CI=0.01, 0.74) compared to HIV-infected YTW who do. No YTW who did not have a primary care provider self-reported being adherent to ART. We observed suboptimal HIV treatment engagement among YTW. Our results suggest that improving linkage and retention in care by addressing financial barriers and improving access to primary care providers could significantly improve health outcomes of YTW as well as reduce forward transmission of HIV.

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Section: Introductionmentioning

confidence: 99%

Burden of HIV among young transgender women: factors associated with HIV infection and HIV treatment engagement

et al. 2018

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“…22 Our findings that 66% of respondents taking ART took their meds all of the time is similar to rates found among other community samples of TGNC PLWH 12,18,20 and lower than nationally representative samples of TGNC PLWH engaged in HIV care. 3,15 The difference in community and nationally representative samples, highlighted again in this study by our findings, is important. One Significance was tested using t-tests with continuous variables, and chi-squared for categorical variables.…”

Section: Discussionmentioning

confidence: 67%

“…26,27 Other factors affecting adherence were related to social instability and included homelessness and ''alternative'' (not renting or owning a home) housing, sex work, and drug use in the past year, not being able to access care because of finances, and experiencing verbal harassment. Some of these factors such as compromised access to care 15 have been supported by existing adherence research with TGNC PLWH, and among PLWH overall, including homelessness, 28 sex work, 29 and drug use. 28,30 As with adherence, different measures across studies may account for variation in risk, although sociostructural vulnerability is a common theme.…”

Section: Discussionmentioning

confidence: 98%

“…However, Mizuno et al measured ''selfreported adherence to prescribed ART dose.'' 15 Among community samples, in a study about dual hormone/ ART use, Braun et al measured adherence as ''taken differently than prescribed due to drug (hormone) interacting concern'' 20 ; Reisner et al defined adherence by asking youth about the last 7 days taking HIV medications, one or more doses missed were categorized as not fully adherent days. 12 There are pros and cons to each measurement approach, but lack of consistency prevents meaningful comparisons.…”

Section: Discussionmentioning

confidence: 99%

“…3 Mizuno et al reported that 80.5% of trans women sampled in the MMP reporting current ART use self-reported adherence to their prescribed ART dose. 15 Both studies described high rates of poverty, unmet service needs, depression, and substance use among transgender men and women. A few smaller community samples (N = 22 to N = 181) report lower ART adherence rates spanning from 55% to 68% among predominantly transgender women samples, although measurement of adherence varies across studies.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Adherence to Antiretroviral Therapy Among Transgender and Gender Nonconforming People Living with HIV: Findings from the 2015 U.S. Trans Survey

2019

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Purpose: This article includes an analysis of medication adherence among transgender and gender nonconforming (TGNC) people living with HIV (PLWH) from the 2015 U.S. Trans Survey (USTS), the largest survey of TGNC people in the United States. Methods: Using data from the USTS, our analytic sample included 162 TGNC PLWH who had been prescribed antiretroviral (ART). We grouped respondents by adherent/nonadherent and compared demographic characteristics and potential adherence risk factors.Results: Approximately 65.8% of participants reported ''taking ART as prescribed'' all the time (61.0% trans women and 85.7% of trans men). Black TGNC PLWH were more likely to be nonadherent than whites or Hispanics. Adherent participants reported higher rates of home ownership. Nonadherent PLWH reported higher rates of verbal harassment, sex work, and homelessness in the past year, and lower rates of visiting an HIV doctor for care in the past year. Conclusions: USTS respondents living with HIV reported lower adherence than in other nationally representative studies of this population in medical care. HIV rates are higher among black individuals, and reported adherence is lower, suggesting this is a high-priority population. Findings also suggest that unstable sociostructural conditions (homelessness, sex work, etc.) compromise medication adherence. Future practice directions include integrating HIV treatment plans into larger support services for TGNC PLWH.

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Pharmacotherapy considerations in transgender individuals living with human immunodeficiency virus

et al. 2021

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Pharmacotherapy considerations are often a concern for transgender individuals who are living with human immunodeficiency virus (HIV) due to concerns for drug–drug interactions between their hormone and antiretroviral therapies. Many of the first‐line therapies offered to patients for the management of HIV have reduced concerns for safety, resistance, and drug–drug interactions. In this review, we highlight common medications and important considerations for caring for transgender people living with HIV.

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Factors Associated with Antiretroviral Therapy Adherence Among Transgender Women Receiving HIV Medical Care in the United States

Cited by 27 publications

References 23 publications

Burden of HIV among young transgender women: factors associated with HIV infection and HIV treatment engagement

Burden of HIV among young transgender women: factors associated with HIV infection and HIV treatment engagement

Adherence to Antiretroviral Therapy Among Transgender and Gender Nonconforming People Living with HIV: Findings from the 2015 U.S. Trans Survey

Pharmacotherapy considerations in transgender individuals living with human immunodeficiency virus

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