Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States

Abstract

Purpose: Little has been reported from population-based surveys on the characteristics of transgender persons living with HIV. Using Medical Monitoring Project (MMP) data, we describe the characteristics of HIV-infected transgender women and examine their care and treatment needs.

Methods: We used combined data from the 2009 to 2011 cycles of MMP, an HIV surveillance system designed to produce nationally representative estimates of the characteristics of HIV-infected adults receiving medical care in the United States, to compare demographic, behavioral, and clinical characteristics, and met and unmet needs for supportive services of transgender women with those of non-transgender persons using Rao-Scott chi-square tests.

Results: An estimated 1.3% of HIV-infected persons receiving care in the United States self-identified as transgender women. Transgender women were socioeconomically more marginalized than non-transgender men and women. We found no differences between transgender women and non-transgender men and women in the percentages prescribed antiretroviral therapy (ART). However, a significantly lower percentage of transgender women compared to non-transgender men had 100% ART dose adherence (78.4% vs. 87.4%) and durable viral suppression (50.8% vs. 61.4%). Higher percentages of transgender women needed supportive services. No differences were observed in receipt of most of supportive services, but transgender women had higher unmet needs than non-transgender men for basic services such as food and housing.

Conclusion: We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.

Keywords: HIV; Medical Monitoring Project (MMP); transgender women.

Figure 1.

Comparison of met and unmet supportive service needs among HIV-infected transgender women (green bars), non-transgender men (blue bars), and non-transgender women (red bars), Medical Monitoring Project, United States, 2009-2011 Abbreviations: ADAP=AIDS Drug Assistance Program Met supportive service need defined as needing and receiving service. Unmet supportive service need defined as needing, but not receiving service.