Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States.

PURPOSE Little has been reported from population-based surveys on the characteristics of transgender persons living with HIV. Using Medical Monitoring Project (MMP) data, we describe the characteristics of HIV-infected transgender women and examine their care and treatment needs. METHODS We used combined data from the 2009 to 2011 cycles of MMP, an HIV surveillance system designed to produce nationally representative estimates of the characteristics of HIV-infected adults receiving medical care in the United States, to compare demographic, behavioral, and clinical characteristics, and met and unmet needs for supportive services of transgender women with those of non-transgender persons using Rao-Scott chi-square tests. RESULTS An estimated 1.3% of HIV-infected persons receiving care in the United States self-identified as transgender women. Transgender women were socioeconomically more marginalized than non-transgender men and women. We found no differences between transgender women and non-transgender men and women in the percentages prescribed antiretroviral therapy (ART). However, a significantly lower percentage of transgender women compared to non-transgender men had 100% ART dose adherence (78.4% vs. 87.4%) and durable viral suppression (50.8% vs. 61.4%). Higher percentages of transgender women needed supportive services. No differences were observed in receipt of most of supportive services, but transgender women had higher unmet needs than non-transgender men for basic services such as food and housing. CONCLUSION We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.

[1]  J. Skarbinski,et al.  Behavioral and clinical characteristics of persons receiving medical care for HIV infection - Medical Monitoring Project, United States, 2009. , 2014, MMWR supplements.

[2]  S. Kalichman,et al.  Food Insecurity and Other Poverty Indicators Among People Living with HIV/AIDS: Effects on Treatment and Health Outcomes , 2014, Journal of Community Health.

[3]  Mallory O. Johnson,et al.  Barriers and Facilitators to Engagement and Retention in Care among Transgender Women Living with Human Immunodeficiency Virus , 2014, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[4]  Richard D Moore,et al.  Retention in care and health outcomes of transgender persons living with HIV. , 2013, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  C. Beyrer,et al.  Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. , 2013, The Lancet. Infectious diseases.

[6]  Christopher H. Johnson,et al.  A Probability Sample for Monitoring the HIV-infected Population in Care in the U.S. and in Selected States , 2012, The open AIDS journal.

[7]  J. Keatley,et al.  HIV/AIDS programming in the United States: considerations affecting transgender women and girls. , 2011, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[8]  A. Carrico,et al.  Antiretroviral Therapy Adherence Among Transgender Women Living With HIV , 2010, The Journal of the Association of Nurses in AIDS Care : JANAC.

[9]  J. Dunn,et al.  The Effects of Housing Status on Health-Related Outcomes in People living with HIV: A Systematic Review of the Literature , 2007, AIDS and Behavior.

[10]  T. Finlayson,et al.  Estimating HIV Prevalence and Risk Behaviors of Transgender Persons in the United States: A Systematic Review , 2007, AIDS and Behavior.

[11]  A. Scott,et al.  A simple method for the analysis of clustered binary data. , 1992, Biometrics.