Transgender women living with HIV were retained in care and/or virally suppressed at lower rates than cisgender women or men, an analysis of the 2016 Ryan White HIV/AIDS Program report found.
The analysis, published in PLOS Medicine, included data on 6,534 transgender women, 143,173 cisgender women and 382,591 cisgender men. Among trans women, HIV care retention and viral suppression rates were 80% and 79%, respectively, compared to cisgender women at 84% each and cisgender men at 81% and 85%, respectively.
Race exacerbated these differences. The gap was especially great among Blacks, where the adjusted prevalence ratio for viral suppression was 0.55 when transgender women were compared to cisgender women or men.
These findings are consistent with smaller observational studies and point to the intersectionality of stigma and discrimination based on race, gender identity, and HIV status that Black trans women experience, study authors noted. They called for reducing barriers to care for this population, as well as conducting similar research among transgender men and gender-diverse people.
Interventions targeted at the Black and Brown transgender community, such as peer navigation, also need to be developed, they added.