1 HIV/STD/Viral Hepatitis Section , Tennessee Department of Health, Nashville, Tennessee.
2 Department of Medicine, Division of Infectious Diseases and Division of Epidemiology, Vanderbilt University School of Medicine , Nashville, Tennessee.
LGBT Health. 2016 Jun;3(3):208-13. doi: 10.1089/lgbt.2015.0078. Epub 2015 Dec 24.
HIV prevalence and outcome disparities among sexual and gender minorities are profound in the United States. Tennessee HIV surveillance practices have not been uniform for transgender status, although data collection capabilities exist. We, therefore, describe current reporting of data on transgender individuals in Tennessee to identify targets for improvement.
Data for all HIV-diagnosed individuals living in Tennessee as of December 31, 2013, were extracted from the Enhanced HIV/AIDS Reporting System (eHARS). The birth_sex ("Male" or "Female") and current_gender ("Male," "Female," "Male-to-Female," "Female-to-Male," or "Additional Gender Identity") variables were examined, and proportion missing current_gender data by region was ascertained. Transgender individuals were defined as having different birth_sex and current_gender values. To ensure the protection of health information, data were cleaned, deidentified, and aggregated using Statistical Analysis Software (SAS) Version 9.3 (SAS Institute, Inc., Cary, NC).
Among 16,063 HIV-diagnosed individuals in Tennessee, 27 were transgender: 52% (n = 14) with "Male-to-Female," 26% (n = 7) with "Female," and 22% (n = 6) with "Male" as their current_gender values. Proportions missing current_gender differed significantly by region across Tennessee (global, P < 0.01).
While HIV-positive transgender individuals should be recognized as integral members of the LGBT community, they should also be acknowledged as a separate subgroup when appropriate. Collecting information about current self-identified gender identity should no longer be optional in Tennessee HIV surveillance. Although making efforts to collect both birth_sex and current_gender mandatory with each interview will improve surveillance, it is critical to train all staff properly on the correct way to inquire about gender identity in a culturally sensitive manner. Revamping data collection methods will not only improve inconsistent methods currently in place but will also allow staff to become more competent in asking the relevant questions and serving transgender individuals.
在美国，性少数群体和性别少数群体中艾滋病毒的流行率和结果差异很大。田纳西州的艾滋病毒监测实践对跨性别者的地位并不统一，尽管有数据收集能力。因此，我们描述了目前田纳西州关于跨性别者数据的报告情况，以确定需要改进的目标。
从增强型艾滋病毒/艾滋病报告系统（eHARS）中提取截至 2013 年 12 月 31 日居住在田纳西州的所有艾滋病毒确诊个体的数据。检查出生性别（“男”或“女”）和当前性别（“男”、“女”、“男变女”、“女变男”或“其他性别认同”）变量，并确定各地区当前性别数据缺失的比例。跨性别者被定义为具有不同出生性别和当前性别值的个体。为了确保保护健康信息，使用统计分析软件（SAS）版本 9.3（SAS Institute，Inc.，Cary，NC）对数据进行清理、去识别和汇总。
在田纳西州的 16063 名艾滋病毒确诊个体中，有 27 名是跨性别者：52%（n=14）为“男变女”，26%（n=7）为“女”，22%（n=6）为“男”作为他们的当前性别值。田纳西州各地的当前性别缺失比例差异显著（全球，P<0.01）。
虽然艾滋病毒阳性的跨性别者应被视为 LGBT 社区的重要成员，但在适当情况下，他们也应被视为一个单独的亚组。在田纳西州的艾滋病毒监测中，收集关于当前自我认同的性别认同信息不应再是可选的。虽然努力使每次访谈都强制收集出生性别和当前性别会改善监测，但对所有工作人员进行正确询问性别认同的文化敏感性的适当培训至关重要。改革数据收集方法不仅可以改进当前不一致的方法，还可以使工作人员更有能力提出相关问题并为跨性别者提供服务。
