HIV Testing Preferences Among Trans Men and Trans Women: A Retrospective Study of Client Records from 2017 to 2019 in a Community-Based Transgender Health Center in Metro Manila, Philippines

Abstract

Background: Transgender individuals are considered as high-risk for contracting HIV infection. Integrating HIV testing and counseling (HTC) services into current transgender health programs is necessary to increase its uptake. Our study aimed to describe the characteristics of trans men (TM) and trans women (TW) who accessed HTC services in a community-based transgender health center in Metro Manila, Philippines, and to examine the relationship between gender identity and their HIV testing preferences. Methods: We conducted a retrospective study of TM and TW seeking care from 2017 to 2019. Medical records of clients were reviewed to ascertain their age, gender identity, year and frequency of clinic visits, lifestyle factors, and HIV testing preferences. The effect of gender identity on HIV testing preferences was estimated using a generalized linear model with Poisson distribution, log link function, and a robust variance, adjusted for confounding variables. Results: Five hundred twenty-five clients were included in the study, of which about four out of five clients declined the HTC services being offered. In addition, the prevalence of non-uptake of HTC services was 48% higher [adjusted Prevalence Ratio (aPR): 1.48; 95% Confidence Interval (CI): 1.31–1.67] among TM compared to TW. Clients who initially consulted in 2017 had a 25% higher prevalence of refusal for HTC services (aPR: 1.25; 95% CI: 1.08–1.43) than clients who initially consulted in 2019. Approximately 4% and 11% of the TM and TW, respectively, who accessed the HTC services were reactive and linked to antiretroviral therapy treatment. Conclusion: HTC service uptake of TM and TW is low. HIV program implementers should strategize solutions to reach this vulnerable population for increased and better HTC service uptake and linkage to care.