Depression, sexual behavior, and HIV treatment outcomes among transgender women, cisgender women and men who have sex with men living with HIV in Brazil and Thailand: a short report

ABSTRACT

One in five transgender women (TW) are living with HIV, yet little has been published about their health outcomes. We analyzed data from TW (n = 37), cisgender women (CW, n = 165), and cisgender men who have sex with men (MSM, n = 151) in Thailand and Brazil. We hypothesized: (1) TW will have higher odds of depressive symptoms, lower odds of condom use and greater odds of a detectable viral load compared to MSM and CW; and (2) TW will have lower odds of condom use and higher odds of detectable viral load. We found that TW had higher odds of depression (OR 2.2, 95%CI: 1.0, 4.8, p = 0.04) and were less likely than MSM (22% v. 42%, p = 0.01) to use condoms with partners of unknown serostatus. In multivariable models, TW had lower odds than MSM of using condoms with partners with unknown serostatus (OR 0.38, 95%CI: 0.15, 0.90) and CW had lower odds than MSM of using condoms with HIV-negative partners (0.60 [0.38, 0.95], p = 0.029). We found no significant differences in detectable viral load. Disaggregating data by gender is important to understand factors that contribute to viral suppression and HIV transmission risk among people living with HIV.

KEYWORDS:

• Transgender
• HIV
• depression
• HPTN
• Brazil
• Thailand

Acknowledgements

The authors would also like to acknowledge the staff at the HPTN 063 study sites for their contributions to the study. We gratefully acknowledge the HTPN Scholars Program for their generous support of this analysis and all the study participants without whom this study would have been impossible.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available the HIV Prevention Trials Network (HPTN at https://www.hptn.org/research/studies). Restrictions apply to the availability of these data, which were used after approval from the HPTN leadership for this study.

ORCID

Kenneth H. Mayer http://orcid.org/0000-0001-7460-733X

Matthew J. Mimiaga http://orcid.org/0000-0001-9256-2905

Steven A. Safren http://orcid.org/0000-0002-0121-0806

Additional information

Funding

HPTN 063 was funded by the Division of AIDS (DAIDS), National Institute of Allergy and Infectious Disease (NIAID), National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH) under Cooperative Agreement # UM1AI068619. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or The HIV Prevention Trials Network. Dr. Poteat’s work on this manuscript was supported by the Johns Hopkins Center for AIDS Research (JHU CFAR) NIH P30AI094189. Dr. Mayer was also supported by the Harvard University Center for AIDS Research (HU CFAR) NIH P30AI060354 and Dr. Safren by grant 9K24DA040489.