Surprising study indicates trans women in gender-affirming care contract HIV less often

transgender women, HIV, Prep, study, CDC
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New research published in The Lancet HIV indicates that transgender women who receive gender-affirming medical care are less likely to contract and transmit HIV. This surprising finding is probably due to the health education trans women get while recieving such care.

The study revealed that about one in 200 trans women in the U.S. contract the immunodeficiency virus each year.

Researchers, led by Dr. Andrea Wirtz of John Hopkins University, followed 1,312 HIV-negative trans women in-person and online in six U.S. cities including Atlanta, Baltimore, Boston, Miami, New York City, and Washington, DC, and through a digital mode in 72 smaller eastern and southern U.S. cities.

The ongoing study started in 2018 and included in-person or online health check-ups.

As of May 2022, 15 individuals had tested positive for HIV infection.

Of those women, seven had never taken pre-exposure prophylaxis (PrEP), and seven had previously been on PrEP but were no longer taking it. One participant declined to answer the question. The findings suggest a deficit of HIV education and access to medication.

Nine women (or 0.33 percent of the total study group) died annually from circumstances including murder and suicide, overdose, cardiac arrest, another health condition, and unknown causes. None of the deaths were related to HIV.

Study participants who sought gender-affirming and transition care were less likely to contract HIV or to die during the study. Researchers attributed this finding to the medical support that accompanies those services, which decreased women’s risks of HIV and death. More vulnerable women may be less likely or able to access gender-affirming care and the medical support that comes with it, the study said.

Research also revealed Black women were more likely to contract HIV over the course of the study. Latinx trans women and trans women who had been arrested within the last 12 months also had a higher incidence of death.

Risk factors that increased the likelihood of HIV and death included stimulant drug use, being in a relationship with a cisgender man, and living in the South.

According to the Centers for Disease Control (CDC), as of 2019, 19 percent of new HIV diagnoses were among cisgender and trans women. An estimated 14% of trans women in the U.S. are now living with HIV.

The Human Rights Campaign calculates that trans women are almost 49 times more likely to test positive for HIV than the general population.

Researchers said the study was a chance, beyond their focus on HIV prevention, to address those indicated risk factors as part of a holistic approach to help vulnerable populations.

They wrote, “A singular focus on HIV prevention is a missed opportunity to address other threats to the lives of people prioritized in HIV services and programming.”

HIV diagnoses are one of the six indicators employed in the public health campaign entitled “Ending the HIV Epidemic in the United States. 

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