SARS-CoV-2 Infection and Testing Experiences in a Nationwide Sample of Transgender and Gender-Diverse Adults, June–December 2021

Abstract

Objectives: COVID-19 surveillance data are rarely collected or disaggregated by gender identity in the United States. We quantified COVID-19 testing experiences and SARS-CoV-2 infection history among transgender and gender-diverse (TGD) people to inform testing strategies and public health responses. Methods: From June 14 through December 16, 2021, TGD adults enrolled in a US nationwide online survey with optional SARS-CoV-2 antibody testing. We used multinomial regression analyses to identify correlates of suspected and confirmed SARS-CoV-2 infection (vs no known infection). We identified correlates of inability to access COVID-19 testing when needed using generalized linear models for binomial variables. Results: Participants (N = 2092) reported trans masculine (30.5%), trans feminine (27.3%), and nonbinary (42.2%) gender identities. Ten percent of respondents had a confirmed history of SARS-CoV-2 infection, and 29.8% had a history of suspected SARS-CoV-2 infection. Nonbinary gender (adjusted prevalence ratio [aPR] = 1.68; 95% CI, 1.12-2.53), experiencing homelessness (aPR = 1.65; 95% CI, 1.05-2.60), and food insecurity (aPR = 1.45; 95% CI, 1.03-2.04) were associated with confirmed SARS-CoV-2 infection. Food insecurity (aPR = 1.38; 95% CI, 1.10-1.72), chronic physical health condition (aPR = 1.44; 95% CI, 1.15-1.80), chronic mental health condition (aPR = 3.65; 95% CI, 2.40-5.56), and increased anticipated discrimination scores (aPR = 1.03; 95% CI, 1.01-1.05) were associated with suspected SARS-CoV-2 infection. Thirty-four percent (n = 694 of 2024) of participants reported an inability to access COVID-19 testing when needed, which was associated with Latinx or Hispanic ethnicity, inconsistent telephone access, homelessness, disability, and transportation limitations. The majority (79.4%) reported a complete COVID-19 vaccine course at the time of participation. Conclusions: Inclusion of TGD people in public health surveillance and tailored public health strategies to address TGD communities’ social and structural vulnerabilities may reduce barriers to COVID-19 testing.

Brief Report: Interruptions in HIV Prevention and Treatment During the COVID-19 Pandemic: A Cross-Sectional Study of Transgender and Gender Nonbinary Adults in the United States

“…A convenience sample of 2134 participants were recruited between June 14, 2021, and May 1, 2022. 11 Recruitment methods included peer referrals, recruitment from existing cohorts of TNB people, and outreach through community networks. Eligibility for enrollment included age 18 years or older, gender different from sex assigned on original birth certificate, and residence within the United States or Puerto Rico.…”