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. 2020 Jan;34(1):16-26.
doi: 10.1089/apc.2019.0067. Epub 2019 Dec 17.

Engagement and Retention in HIV Care for Transgender Women: Perspectives of Medical and Social Service Providers in New York City

Walter Bockting  1 , Caitlin MacCrate  1 , Hayley Israel  1 , Joanne E Mantell  1 , Robert H Remien  1
Affiliations

Engagement and Retention in HIV Care for Transgender Women: Perspectives of Medical and Social Service Providers in New York City

Walter Bockting et al. AIDS Patient Care STDS. 2020 Jan.

Abstract

Transgender women are less likely to engage in HIV care and adhere to antiretroviral medications than other at-risk populations. Health care and social service providers, in addition to consumers, have experiences that can elucidate barriers and facilitators to care and inform interventions. Guided by the social/ecological model, we conducted interviews with 19 providers working with transgender women. At the health systems level, perceived barriers included lack of care accessibility and security, providers' misunderstanding of the transgender community, and lack of cultural competency of information systems and staff. At the community level, barriers included HIV stigma. At the family level, barriers included rejection and housing instability. At the individual level, barriers included conflicts between HIV- and transgender care, medication side effects, competing priorities, mental health issues and substance abuse, and low health literacy. Facilitators included provider competence in transgender health, improved access to care, and patient empowerment. Findings indicate the need for an integrated care model.

Keywords: access to care; engagement in care; retention in care; transgender.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
Barriers and facilitators to engagement and retention in HIV care by level of the social/ecological model.
See this image and copyright information in PMC

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