New Resources Address HIV in Transgender Communities

Transgender women are among the priority populations in the National HIV/AIDS Strategy because of the disproportionate impact of HIV they experience. Three recent resources from the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) are focused on HIV prevention and care in transgender communities.

The first is a CDC issue brief discussing topics specific to HIV and transgender communities. These topics include available data on HIV prevalence and diagnoses, systemic factors that contribute to high rates of HIV among transgender populations, and CDC’s partnership efforts with community-based organizations (CBOs) to intensify HIV prevention and care services in affected populations.

Second is a new CDC MMWR article, Factors Associated with Use of HIV Prevention and Health Care Among Transgender Women — Seven Urban Areas, 2019–2020, that examines structural and health care factors among transgender women that affect their HIV prevention or treatment outcomes. The article notes that among transgender women participating in the survey, experiencing homelessness, poverty, and food insecurity were common and associated with lower likelihood of viral suppression among transgender women with HIV infection. In addition, having a usual source of health care and comfort with a provider were associated with a higher likelihood of viral suppression, HIV testing, and pre-exposure prophylaxis (PrEP) use, all of which play key roles in HIV prevention. The findings underscore that gender-affirming health care is critical to connecting transgender women to HIV prevention and care services, but conclude that access to food, housing, and income are also essential.

The final resource, Transgender Clients Served by the Ryan White HIV/AIDS Program, 2020, is a slide deck from HRSA. It provides aggregate data on over 11,000 transgender clients with HIV, including demographic information, such as housing type and health care coverage, as well as viral suppression rates. Here, HRSA emphasizes that although the proportion of transgender clients whose virus is suppressed has risen over the past decade, transgender clients have a lower a rate of viral suppression than Ryan White HIV/AIDS Program (RWHAP) clients overall. The slides also provide detail on the sub-populations of transgender clients whose viral suppression is lower than the RWHAP average and the average for all transgender clients, including younger clients and clients with unstable or temporary housing.

Across these three resources, federal partners have brought together information that can be used to inform efforts by health departments, health care providers, CBOs, and other stakeholders to improve HIV services for transgender individuals.