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Four in 10 transgender women have HIV, which shows the urgent need to offer them more prevention and treatment services, according to a new U.S. Centers for Disease Control and Prevention report.
In interviews with more than 1,600 transgender women in Atlanta, Los Angeles, New Orleans, New York City, Philadelphia, San Francisco and Seattle in 2019 and early 2020, researchers found that 42% of those with a valid HIV test result had HIV. Transgender women are those assigned male at birth and identify as female.
The report found significant racial and ethnic disparities. In all, 62% of Black transgender women and 35% of Hispanic transgender women had HIV, compared with 17% of white transgender women.
Nearly two-thirds of those surveyed lived at or below the poverty level. Forty-two percent had been homeless in the past year.
“These data provide a clear and compelling picture of the severe toll of HIV among transgender women and the social and economic factors—including systemic racism and transphobia—that are contributing to this unacceptable burden,” said Dr. Demetre Daskalakis, director of the CDC’s Division of HIV/AIDS Prevention.
The report was released in advance of National Transgender HIV Testing Day on April 18.
“Reducing HIV in these communities will require that public health and other providers of social and prevention services design innovative and comprehensive status-neutral solutions to overcome barriers to whole person prevention and care,” Daskalakis said in a CDC news release.
Status-neutral means continuous HIV prevention, care and treatment regardless of a person’s HIV status.
“HIV testing is the gateway to all treatment and prevention, and expanding testing means more transgender women are aware of their status and can engage in the care they need—if we help them connect to appropriate and responsive care services,” said Joseph Prejean, acting deputy director for surveillance, epidemiology and laboratory science in the CDC’s Division of HIV/AIDS Prevention.
The report also assessed use of prevention services.
Only 32% of HIV-free respondents said they used pre-exposure prophylaxis (PrEP). PrEP is recommended for people who are at risk of HIV exposure from sex or injection drug use. Taken as prescribed, it is highly effective at preventing HIV.
Previous research has shown that low use of PrEP among transgender women may owe to several factors, including medical mistrust due to experiences of transphobia; lack of trans-inclusive marketing, and concerns about drug interactions between hormones and PrEP.
About 67% of the HIV-free transgender women who participated in the study were taking hormones for gender affirmation.
HealthDay