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.
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