Comprehensive HIV Prevention for Transgender Persons

Neumann, Mary Spink; Finlayson, Teresa; Pitts, Nicole; Keatley, JoAnne

doi:10.2105/ajph.2016.303509

Cited by 49 publications

(41 citation statements)

References 40 publications

(46 reference statements)

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“…Half (50%) of the participants identified as transgender women, 38% as cisgender men, and 12% as transgender men. Participant median age was 26 years (range [18][19][20][21][22][23][24][25][26][27][28][29].…”

Section: Resultsmentioning

confidence: 99%

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Outcomes of a PrEP Demonstration Project with LGBTQ Youth in a Community-Based Clinic Setting with Integrated Gender-Affirming Care

et al. 2020

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Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are disproportionately affected by HIV, and young transgender women (YTW) are especially impacted. The purpose of this small demonstration project was to measure pre-exposure prophylaxis (PrEP) adherence in a community-based clinic for LGBTQ youth in which PrEP services are integrated with gender-affirming care. Of the 50 enrolled participants, 38 had a serum drug assay performed after three or more months and 26% of those had laboratory evidence of highly protective levels of medication. Low adherence highlights the need for culturally tailored follow-up efforts and assistance with the structural barriers to health experienced by LGBTQ youth, especially YTW.

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Section: Resultsmentioning

confidence: 99%

“…services that are affirming to transgender residents. 25 Future research on the role these factors play in PrEP adherence is vital to supporting a group of young people who are disproportionately impacted by HIV.…”

mentioning

confidence: 99%

Outcomes of a PrEP Demonstration Project with LGBTQ Youth in a Community-Based Clinic Setting with Integrated Gender-Affirming Care

et al. 2020

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“…To decrease disparities and achieve health equity among transgender men, HIV care models could incorporate transgender-sensitive health care and mental health services and health insurance inclusive of sex reassignment procedures and physical sex–related care. 12 Although more information is needed to understand how health professionals can improve the health and well-being of transgender men living with HIV in the United States, MMP data provide the first national estimates of important sociodemographic, clinical, and behavioral characteristics among this population.…”

Section: Public Health Implicationsmentioning

confidence: 99%

Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009–2014

Lemons¹,

Beer²,

Finlayson³

et al. 2018

Am J Public Health

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Objectives To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. Methods This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Results Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Conclusions Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.

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“…2,7 A complex combination of individual, community, and structural factors, including TGNC stigma and discrimination, contributes to the risk TGNC people face for HIV and compromise their ability to access and adhere to antiretroviral (ART) treatment once they have the virus. 2,4,8,9 Such stigma and discrimination are associated with poor mental health, substance abuse, violence, lack of familial and social support, homelessness, and unemployment-all of which compromise HIV care. 2,9 Additional barriers include TGNC people's limited access to and engagement in medical care, including HIV care, [10][11][12] and lack of knowledge and sensitivity among health care providers to treat TGNC people and address their needs.…”

Section: Introductionmentioning

confidence: 99%

“…2,4,8,9 Such stigma and discrimination are associated with poor mental health, substance abuse, violence, lack of familial and social support, homelessness, and unemployment-all of which compromise HIV care. 2,9 Additional barriers include TGNC people's limited access to and engagement in medical care, including HIV care, [10][11][12] and lack of knowledge and sensitivity among health care providers to treat TGNC people and address their needs. 11,13 Advances in HIV treatment, however, have created opportunities for people living with HIV (PLWH) to live longer and healthier lives.…”

Section: Introductionmentioning

confidence: 99%

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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Comprehensive HIV Prevention for Transgender Persons

Cited by 49 publications

References 40 publications

Outcomes of a PrEP Demonstration Project with LGBTQ Youth in a Community-Based Clinic Setting with Integrated Gender-Affirming Care

Outcomes of a PrEP Demonstration Project with LGBTQ Youth in a Community-Based Clinic Setting with Integrated Gender-Affirming Care

Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009–2014

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

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