HIV prevalence, engagement in care, and risk behavior among trans women, San Francisco: Evidence of recent successes and remaining challenges. (October 2022)

• Record Type: Journal Article
• Authors: Chiu, Izzy; Leathers, Matisse; Cano, Damiana; Turner, Caitlin M; Trujillo, Dillon; Sicro, Sofia; Arayasirikul, Sean; Taylor, Kelly D; Wilson, Erin C; McFarland, Willi
• Is Part Of: International journal of STD & AIDS. Volume 33:Number 12(2022)
• Page Start: 1029
• Page End: 1037
• Publication Date: 2022-10
• Subjects: transgender persons -- HIV infections -- sexual partners -- HIV care -- HIV prevention; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/09564624221111278
• Languages: English
• ISSNs: 0956-4624

Abstract

Background: Trans women have high HIV prevalence and lag behind 90–90-90 targets for HIV care. In San Francisco in 2017, 96% of trans women were aware of their status, 75% were on antiretroviral therapy, 88% had viral suppression. Initiatives to address gaps include peer navigators, free gender-affirming surgery, and housing. Our study updates HIV prevalence and engagement in care among trans women. Methods: Cross-sectional community-based survey of trans women living in San Francisco sampled by respondent-driven sampling, 7/2019–2/2020 ( N = 201). Eligibility was: self-identified trans women or other gender and assigned male at birth; living in San Francisco; English/Spanish-speaking; and 18 years or older. Results: HIV prevalence was 42.3% (95%CI 35.4.-49.4) and associated with having a partner who injected drugs (adjusted odds ratio [AOR] 3.30, 95%CI 1.58–6.90), ever injected drugs (AOR 2.28, 95%CI 1.06–4.89), cost not a barrier to healthcare (AOR 2.63, 95%CI 1.02–6.67), emotional support from family (AOR 2.85, 95%CI 1.43–5.65), and Black/African-American (AOR 2.59, 95%CI 1.16–5.79). Of trans women with HIV, 92.9% were previously diagnosed, 89.9% were on ART, 91.5% reported viral suppression. Conclusions: Trans women met 90–90–90 targets in 2020, at 93–90–92. Interventions need to reach Black/African-American trans women, trans women who inject drugs, and partners of trans women.