A study published in the Journal of Acquired Immune Deficiency Syndrome discusses the challenges HIV+ Transgender women face (socioeconomic status, comorbidities, and access to gender-affirming care), which differs from that of HIV+ cisgender men who have sex with men.
Data from the Centers for Disease Control and Prevention (CDC) shows that Transgender women have a 66 times higher risk of the human immunodeficiency virus (HIV) than the general population. The risk is even greater for transgender women of color. However, limited research and inadequate data collection on gender identity make it difficult to understand the factors contributing to these disparities and to improve HIV care for transgender women.
“Transgender women of color are so often conflated with cisgender sexual minority men [cis-SMM]. The groups are treated synonymously, and lumped together,” said Jules Chyten-Brennan, DO, the study’s lead author.
For this study, Chyten-Brennan and his team analyzed 11,562 patients’ electronic health records to evaluate their retention in care, Antiretroviral therapy (ART) prescriptions, and viral suppression over a median of four years. Retention in care was measured as having two or more HIV-related lab results for at least three months within a year.
Of the patients analyzed, 166 were transgender women, 1936 cis-SMM, 4715 non-SMM (cisgender men), and 4745 cisgender women.
The researchers found that transgender women and cis-SMM had similar HIV outcomes. However, they found that compared with cis-SMM, trans women taking estrogen had better care retention (adjusted risk ratio {aRR} 1.15) compared to those who were not taking it (aRR 0.92).
According to Chyten-Brennan, estrogen receipt was a surrogate for gender-affirming care. The study found that those who take estrogen have a higher chance of receiving ART and achieving viral suppression than those who don’t take estrogen. On the other hand, transgender women who do not take estrogen are more likely to have lower rates of ART and viral suppression.
“There are many overlapping challenges, but there’s added health needs amongst trans populations for gender affirmation,” he explained. “When we stratified by whether people were receiving estrogen as a surrogate for gender-affirming care, the outcomes were better.”
The researchers advocate that the impact of estrogen prescription on the disparities in outcomes in transgender women and cis-SMM be considered in HIV research.
Source: Medscape
