Transgender women with HIV continue to experience challenges with retention in care, but those who are engaged in care achieve viral suppression at a rate comparable to that of cisgender women and men of a similar age, race and HIV risk group, researchers reported.
“We want all people living with HIV to have the opportunity to achieve their best health. We know that transgender women bear a disproportionate burden of HIV, and it’s important to ensure that they have equitable access to care and treatment,” Tonia Poteat, PhD, assistant professor in the department of social medicine at the University of North Carolina School of Medicine, told Infectious Disease News.
“Identifying transgender women by creating the North American Transgender Cohort Collaboration (NA-TRACC) and analyzing their data, separate from cisgender people, allowed us to determine where there may be disparities.”
analyzed annual HIV care continuum outcomes by gender status from January 2001 through December 2015 among adults aged 18 years or older enrolled in the NA-TRACC, a subset of 15 clinical cohorts within the North American AIDS Cohort Collaboration on Research and Design. The study included 396 transgender women, 14,094 cisgender women and 101,667 cisgender men.
Poteat summarized the study, explaining that transgender women were less likely to be retained in HIV care over time than cisgender women or cisgender men, although transgender women who were retained in care did not differ from cisgender participants in their rates of viral suppression.
According to the study, a similar proportion of transgender women and cisgender women were virally suppressed over time — 36% in 2001 and 80% in 2015 compared with 35% in 2001 and 83% in 2015, respectively. Both groups had lower rates than those of cisgender men (41% in 2001 and 87% in 2015), but the adjusted differences were not statistically significant, Poteat and colleagues reported.
“In the care of transgender women living with HIV, we need better ways to engage transgender women in HIV care,” Poteat concluded. “If our clinical care sites are successful in engaging transgender women in care, they seem to do as well as everyone else in achieving viral suppression.”
Researchers will use NA-TRACC for additional studies. According to Poteat, they are currently conducting an analysis of cardiovascular comorbidities among transgender women in this cohort.
“Heart disease is an important issue for all people living with HIV, and transgender women who take hormones have been shown to have higher risk. However, we have very little data on heart disease among transgender women living with HIV. We want to provide [these] data to help clinicians and patients make evidence-informed decisions,” Poteat said. – by Caitlyn Stulpin
Disclosures: Poteat reports receiving research funding from ViiV Healthcare and Gilead Sciences. Please see the study for all other authors’ relevant financial disclosures.