Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States

Mizuno, Yuko; Frazier, Emma L.; Huang, Ping; Skarbinski, Jacek

doi:10.1089/lgbt.2014.0099

Cited by 75 publications

(61 citation statements)

References 10 publications

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“…TWLWH reported lower adherence to medications than non-transgender men, and the difference in adherence between TWLWH and non-transgender women approached statistical significance, supporting past findings (Mizuno et al, 2015; Sevelius et al, 2014; Sevelius et al, 2010). As expected, lower adherence among the TWLWH in this sample was associated with detectable viral loads and failure to achieve viral suppression, further supporting literature that adherence to medications is positively related to virologic outcomes (Cantudo-Cuenca et al, 2014; Mizuno et al, 2015). …”

Section: Discussionsupporting

confidence: 83%

“…Furthermore, multiple studies support that transgender women living with HIV (TWLWH) were less likely to report higher adherence to anti-retroviral therapy (ART) compared to other adults with HIV (Sevelius, Carrico, & Johnson, 2010; Mizuno, Frazier, Huang & Skarbinski, 2015). In TWLWH, ART adherence has been associated with older age, abstinence from alcohol, positive gender affirmation and adherence to hormones (Sevelius, Saberi, & Johnson, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Medication adherence among transgender women living with HIV

2016

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Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the U.S. report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transgender women. This secondary analysis is based on data collected from the Symptom and Genetic Study that included a convenience sample of 22 self-identified transgender women, 201 non-transgender men, and 72 non-transgender women recruited in northern California. Self-reported medication adherence was assessed using the AIDS Clinical Trials Group Adherence Questionnaire. Gender differences in demographic and clinical variables were assessed, as were differences between transgender women reporting high and low adherence. Transgender women had lower adherence to medications compared to non-transgender males and non-transgender females (p=.028) and were less likely to achieve viral suppression (p=.039). Within the transgender group, Black/African Americans reported better adherence than participants who were Whites/Caucasian or other races (p=.009). Adherence among transgender women was unrelated to medication count and estrogen therapy, but consistent with other reports on the HIV population as a whole; transgender women with high adherence were more likely to achieve viral suppression compared to the transgender women with low adherence. Despite the high incidence of HIV infection in the transgender population, few studies focus on TWLWH, either in regard to their adherence to antiretroviral therapies or to their healthcare in general. To address ongoing health disparities, more studies are needed focusing on the transgender population’s continuum of care in HIV therapies.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Medication adherence among transgender women living with HIV

2016

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“…Studies that assess transwomen's HIV care continuum indicators, specifically access to HIV care, antiretroviral therapy (ART) utilization and viral suppression are limited. The few studies we found indicated that transwomen have low HIV testing rates and low awareness of HIV status, low engagement and retention in HIV care, low medication adherence and low virologic suppression rates [4][5][6]. Suboptimal HIV engagement rates were found among transwomen from Brazil and US transgender youth [7,8].…”

Section: Introductionmentioning

confidence: 79%

Successes and final challenges along the HIV care continuum with transwomen in San Francisco

et al. 2019

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Introduction To examine the HIV care continuum for transwomen living in San Francisco and to determine factors associated with poor HIV ‐related health outcomes. Methods Data were collected from 2016 to 2017 with transwomen in San Francisco. Respondent‐driven sampling ( RDS ) was used to recruit a population‐based sample. Bivariate associations were assessed, and RDS ‐weighted multivariable logistic regression was used to identify associations between exposures and outcomes along the HIV care continuum. Results Of the 123 self‐identified transwomen in this analysis, ages ranged from 23 to 71 years with a majority identifying as Latina (40.8%) and African American (29.2%). An estimate of 14.3% of participants were not engaged in care, 13% were not currently on antiretroviral therapy ( ART ), 22.2% had a self‐reported detectable viral load and 13.5% had unknown viral load. Those using hormones had lower odds of not being on ART compared to those who did not use hormones. Those with unstable housing had a higher relative risk ratio of having a detectable viral load. Those who experienced both anti‐trans discrimination and racism had higher odds of not being in HIV care. Conclusions San Francisco has made substantial progress engaging transwomen in the HIV care continuum, but the final push to ensure viral suppression will require addressing social determinants. Future interventions to increase HIV care engagement, ART use and viral suppression among transwomen must address housing needs and risks related to the overlapping effect of both anti‐trans discrimination and racism.

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“…First, we performed the first analysis of national surveillance data for transgender people with newly diagnosed HIV infection, providing results that can be used to supplement other analyses on HIV-related risk behaviors and/or transmission categories for transgender people [5, 20, 57, 67, 72]. Second, racial and regional disparities are evident.…”

Section: Discussionmentioning

confidence: 99%

Diagnosed HIV Infection in Transgender Adults and Adolescents: Results from the National HIV Surveillance System, 2009–2014

et al. 2016

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Publications on diagnosed HIV infection among transgender people have been limited to state- or local-level data. We analyzed data from the National HIV Surveillance System and present results from the first national-level analysis of transgender people with diagnosed HIV infection. From 2009 to 2014, HIV surveillance jurisdictions from 45 states plus the District of Columbia identified and reported at least one case of newly diagnosed HIV infection for transgender people; jurisdictions from 5 states reported no cases for transgender people. Of 2351 transgender people with newly diagnosed HIV infection during 2009–2014, 84.0% were transgender women (male-to-female), 15.4% were transgender men (female-to-male), and 0.7% were additional gender identity (e.g., gender queer, bi-gender). Over half of both transgender women (50.8%; 1002/1974) and men (58.4%; 211/361) with newly diagnosed HIV infection were non-Hispanic black/African American. Improvements in data collection methods and quality are needed to gain a better understanding of HIV burden among transgender people.

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Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States

Abstract: We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.

Cited by 75 publications

References 10 publications

Medication adherence among transgender women living with HIV

Medication adherence among transgender women living with HIV

Successes and final challenges along the HIV care continuum with transwomen in San Francisco

Diagnosed HIV Infection in Transgender Adults and Adolescents: Results from the National HIV Surveillance System, 2009–2014

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