Transgender Women Living with HIV Frequently Take Antiretroviral Therapy and/or Feminizing Hormone Therapy Differently Than Prescribed Due to Drug–Drug Interaction Concerns

Braun, Hannan M.; Candelario, Jury; Hanlon, Courtney; Segura, Eddy R.; Clark, Jesse L.; Currier, Judith S.; Lake, Jordan E.

doi:10.1089/lgbt.2017.0057

Cited by 53 publications

(32 citation statements)

References 29 publications

(29 reference statements)

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“…4,5,12 To our knowledge, this is the first exploration of ART adherence using data from the USTS. 22 Our findings that 66% of respondents taking ART took their meds all of the time is similar to rates found among other community samples of TGNC PLWH 12,18,20 and lower than nationally representative samples of TGNC PLWH engaged in HIV care. 3,15 The difference in community and nationally representative samples, highlighted again in this study by our findings, is important.…”

Section: Discussionsupporting

confidence: 76%

“…A few smaller community samples (N = 22 to N = 181) report lower ART adherence rates spanning from 55% to 68% among predominantly transgender women samples, although measurement of adherence varies across studies. 12,[16][17][18][19][20] Community studies of transgender populations report adherence barriers such as negative health care experiences 16 and transphobia. 12 The National HIV/AIDS Strategy for the United States calls for improving health outcomes and decreasing health disparities among transgender people.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 76%

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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“…47,48 This may be due to having increased risk factors associated with nonadherence to antiretroviral therapy, such as poverty, housing instability, physical and emotional trauma, 49,50 prioritization of other health issues, 51 or concern about the potential for drug inter-actions between their hormone therapy and antiretroviral agents. 52,53 Medical providers can also help to diminish some of the HIV-related health disparities that transgender people face. This starts with assessing risk for HIV and sexually transmitted diseases.…”

Section: Hivmentioning

confidence: 99%

Addressing Needs of Transgender Patients: The Role of Family Physicians

Radix

2020

J Am Board Fam Med

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There are approximately 1 million transgender and gender-diverse adults in the United States. Despite increased awareness and acceptance, they frequently encounter medical settings that are not welcoming and/or health care providers who are not knowledgeable about their health needs. Use of correct terminology, following best practices for name and pronoun use, and knowledge of gender-affirming interventions can create office environments that are welcoming to transgender clients. Health disparities faced by transgender patients that impact access to care include higher rates of mental health issues, substance use disorders, violence, and poverty. Transgender women are at greater risk for HIV acquisition and are less likely to achieve viral suppression compared with cisgender (nontransgender) individuals. Medical providers can facilitate HIV prevention efforts by offering pre-and postexposure prophylaxis to transgender patients at risk for HIV infection. Improving health outcomes requires attention to cultural competency and an understanding of lived experiences and priorities of transgender people.

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“…As a result, ∼40% of HIV-infected TG women used feminizing hormone therapies and/or antiretroviral therapy differently than prescribed. 95 This raises concerns regarding suboptimal adherence to antiretroviral therapy and the possibility of increased risk of developing resistance to antiretroviral therapy, virologic failure, and increased transmission to sexual partners, especially drug-resistant HIV. 96–99…”

Section: Tg Individuals and Stdsmentioning

confidence: 99%

The Evolving Role of Pharmacists in Transgender Health Care

Redfern

Jann

2019

Transgender Health

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Pharmacists are increasingly part of a multifaceted team providing health care to members of the often marginalized transgender (TG) community. Some pharmacists, however, may feel unprepared to care for and interact with TG individuals. By providing comprehensive, respectful, and gender-affirming support, improving physical pharmacy environments with policies and procedures, pharmacists can be trustworthy providers for TG patients. This review focuses primarily on the health issues of TG persons and the pharmacist's role in promoting health, identifying barriers to health care, and providing health care resources for TG persons. The evolution of psychiatric diagnostic criteria, access to health care, and inclusion of TG, lesbian, gay, and bisexual topics in the educational curriculum are presented. Cultural competency and diversity training that addresses gender identity and sexual orientation issues should be important interdisciplinary and interprofessional activities for all health care professional education programs. Pharmacists play a key role in the health care needs of TG persons that include appropriate laboratory monitoring, complex pharmacotherapeutic challenges, and providing unbiased gender-affirming interactions. The pharmacy's physical environment, staff training, and policies and procedures can offer unique services to TG persons.

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Transgender Women Living with HIV Frequently Take Antiretroviral Therapy and/or Feminizing Hormone Therapy Differently Than Prescribed Due to Drug–Drug Interaction Concerns

Cited by 53 publications

References 29 publications

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

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

Addressing Needs of Transgender Patients: The Role of Family Physicians

The Evolving Role of Pharmacists in Transgender Health Care

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