Rapid HIV Testing in Transgender Communities by Community-Based Organizations in Three Cities

Abstract

SYNOPSISObjectives. This article describes the demographic and behavioral characteristics, human immunodeficiency virus (HIV) testing history, and results of HIV testing of transgender (TG) people recruited for rapid HIV testing by community-based organizations (CBOs) in three cities.Methods. CBOs in Miami Beach, Florida, New York City, and San Francisco offered TG people rapid HIV testing and prevention services, and conducted a brief survey. Participants were recruited in outreach settings using various strategies. The survey collected information on demographic characteristics, HIV risk behaviors, and HIV testing history.Results. Among 559 male-to-female (MTF) TG participants, 12% were newly diagnosed with HIV infection. None of the 42 female-to-male participants were newly diagnosed with HIV. A large proportion of MTF TG participants reported high-risk behaviors in the past year, including 37% who reported unprotected receptive anal intercourse and 44% who reported commercial sex work. Several factors were independently associated with increased likelihood of being newly diagnosed with HIV infection among MTF TG participants, including having a partner of unknown HIV status in the past year; being 20-29 or 40 years of age; having last been tested for HIV more than 12 months ago; and having been recruited at the New York City site.Conclusions. Based on the high proportion of undiagnosed HIV infection among those tested, TG people represent an important community for enhanced HIV testing and prevention efforts. MTF TG people should be encouraged to have an HIV test at least annually or more often if indicated, based upon clinical findings or risk behaviors. Efforts should continue for developing novel strategies to overcome barriers and provide HIV testing and prevention services to TG people.

A Mixed Methods Study of the Sexual Health Needs of New England Transmen Who Have Sex with Nontransgender Men

“…[1][2][3][4][5][6][7][8][9][10][11] However, the inclusion of transmen in studies of HIV sexual risk behavior remains uncommon. 1,2,4,[11][12][13][14][15] The current state of knowledge of HIV and STD risk among transgender men may be influenced by a common assumption that transmen only engage in sexual behavior with nontransgender women (i.e., presumed heterosexual orientation), and not with nontransgender men. However, transmen have diverse sexual identities, desires, and behaviors, including being attracted to and engaging in sexual behavior with nontransgender men, nontransgender women, and other transgender individuals, including transmen and transwomen.…”

Laboratory Evaluation of Three Rapid Diagnostic Tests for Dual Detection of HIV and Treponema pallidum Antibodies

“…The advantage of such testing is that results are immediately available at the point of care, which provides early diagnosis of HIV infection and improved linkage to care (13)(14)(15). In contrast, FDA-approved, CLIA-waived point-of-care tests for the diagnosis of syphilis are not yet available in the United States, although such tests are available in other countries (16).…”

Costs And Effectiveness of Finding New HIV Diagnoses by Using Rapid Testing In Transgender Communities

“…Staff at participating sites provided pretest counseling and posttest risk reduction counseling to all participants who were tested. Oral fluid or whole-blood specimens were collected for confirmatory testing by Western blot from persons who had reactive rapid test results (Greenwald et al, 2006;Schulden et al, 2008). In addition, staff at participating sites administered a brief survey to participants to collect information on demographic characteristics, risk behaviors, and HIV testing history.…”

“…In addition, staff at participating sites administered a brief survey to participants to collect information on demographic characteristics, risk behaviors, and HIV testing history. Because only 7% of total number of transgender persons served by the programs were FTM transgender persons, we combined MTF and FTM data in our analysis (Schulden et al, 2008). The details on recruitment methods and HIV testing protocols are described elsewhere (Schulden et al, 2008).…”

“…In one demonstration project under this initiative, the CDC funded 3 community-based organizations (CBOs), one each in New York City, San Francisco, and Miami Beach, to provide rapid HIV counseling and testing services to transgender persons. HIV testing outcomes, risk behavior, and demographic characteristics of transgender persons served by this demonstration project have been reported elsewhere (Schulden et al, 2008). In this analysis we assessed the project's costs and cost-effectiveness in New York City and San Francisco.…”