HIV epidemics among transgender women

Abstract

Purpose of review Recent data on the high burden of HIV among transgender women has stimulated interest in addressing HIV in this vulnerable population. This review situates the epidemiologic data on HIV among transgender women in the context of the social determinants of health and describes opportunities for effective interventions. Recent findings Transgender women experience unique vulnerability to HIV that can be attributed to multi-level, intersecting factors that also influence the HIV treatment and care continuum. Stigma and discrimination, lack of social and legal recognition of their affirmed gender, and exclusion from employment and educational opportunities represent fundamental drivers of HIV risk in transgender women worldwide. Summary Interventions to improve engagement in HIV prevention, testing, care, and treatment among transgender women should build on community strengths and address structural factors as well as psychosocial and biologic factors that increase HIV vulnerability and prevent access to HIV services.

Attitudes, Beliefs, and Barriers to PrEP Among Trans Men

“…Only one participant stated that he might consider not using a condom if his partner were using PrEP. These statements support previous findings that, despite having risk factors, the HIV prevalence among trans men is much lower than that among cisgender gay men or trans women (Feldman, Romine, & Bockting, 2014;Herbst et al, 2008;Poteat, Reisner, & Radix, 2014;World Health Organization, 2015). These findings also contradict other studies that found that trans men reported unsafe sex due to unequal power dynamics with cisgender gay men (Rowniak et al, 2011;Sevelius, 2009).…”

Características en hombres que tienen sexo con hombres VIH+ en Cali-Colombia 2012-2015

“…Estos resultados son similares a los reportados por estudios a nivel del país en dichas poblaciones donde predomina una baja escolaridad [3,4,6] y mayor probabilidad de tener infección por vih en personas mayores de 25 años [4]. En este mismo sentido, también se ha reportado menor escolaridad y pocas oportunidades sociales en las poblaciones hsh y trans [22][23][24].…”

HIV Infection among Transgender Women: Challenges and Opportunities

“…Violence and abuse among transgender women has been associated with HIV infection and sexual risk-taking in this population [12]. These problems collectively create further social barriers to healthcare, including HIV prevention and treatment programs [7]. Indeed, recent studies have revealed low rates of HIV testing and adherence to antiretroviral therapy among transgender women, as well as elevated rates of HIV-related mortality [13][14][15].…”

“…In many settings, the risk of HIV infection among transgender women occurs through multiple pathways, including high-risk drug use, sex work, and injection with hormones or other products such as silicone and industrial oils [9,10]. These risks are further exacerbated by extreme levels of violence experienced by transgender women, low levels of gender-competent care among healthcare providers, as well as stigma and discrimination experienced within various public and nonpublic settings, including healthcare facilities [7,11]. Violence and abuse among transgender women has been associated with HIV infection and sexual risk-taking in this population [12].…”

“…Transgender women are individuals born as males but who later assume a feminine gender expression or identity [7]. Evidence from various settings suggests that transgender women often contend with high rates of HIV infection.…”