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HIV-positive transgender men in US have significant unmet medical and social needs
Michael Carter, 2017-12-06 08:00:00
HIV-positive transgender men in the
United States have significant unmet social and healthcare needs, according to a
study published in Research and Practice.
Approximately half were living in poverty and only 60% had sustained viral
“Many transgender men receiving HIV
medical care in the United States face socioeconomic challenges and suboptimal health
outcomes,” write the authors. “Although these transgender men had access to HIV
medical care, many experienced poor health outcomes and unmet needs.”
Transgender people experience
poorer health outcomes compared to cisgendered individuals (people whose
current gender identity is the same as the one with which they were born).
Little is known about
characteristics and outcomes of HIV-positive transgender men (designated female at birth).
A team of investigators therefore analysed the records of patients who received
HIV care in the United States between 2009 and 2014. Their aim was to
characterise the sociodemographic and clinical characteristics of these
Overall, transgender men
constituted 0.16% of all adults but 11% of transgender adults receiving HIV
care in the United States. The majority (59%) were aged between 18 to 49 years and 40% identified as
gay or bisexual. Although 42% had completed high school, almost half (47%) had
an income below the national poverty level. A third were uninsured or relied on
a Ryan White programme for their health care. Over two-thirds (69%) had an
unmet support need and a quarter were currently living with depression.
Most (53%) were sexually active.
The majority (57%) had been living
with HIV for ten or more years; a quarter had a history of an AIDS diagnosis. The vast
majority (93%) had ever taken antiretrovirals; 88% were on HIV therapy and 83%
were fully adherent to their treatment. Last viral load measurement was
undetectable in 69% and 57% had a current CD4 cell count above 500 cells/mm3.
Two-thirds of patients had a viral load test every six months but only 40% had
received sexual health or HIV prevention counselling from a healthcare
“More than 1 in 10 transgender
persons receiving HIV care were transgender men. HIV-positive transgender men
receiving medical care in the United States constitute a small group with
socioeconomic challenges, unmet needs for supportive services, and poor healthcomes,”
conclude the authors. “To decrease disparities and achieve health equity among
HIV-positive men, HIV care models could incorporate transgender-sensitive
health care and mental health services and health insurance inclusive of sex
reassignment procedures and physical sex-related care.”