Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia .
LGBT Health. 2015 Sep;2(3):228-34. doi: 10.1089/lgbt.2014.0099. Epub 2015 Apr 28.
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.
目的:基于人群的调查中鲜有关于感染 HIV 的跨性别者特征的报道。本研究利用医疗监测项目(MMP)的数据,描述感染 HIV 的跨性别女性的特征,并探讨其护理和治疗需求。
方法:我们结合了 MMP 2009 至 2011 年周期的数据,MMP 是一个旨在生成美国接受医疗护理的 HIV 感染者特征的全国代表性估计的 HIV 监测系统,使用 Rao-Scott 卡方检验比较跨性别女性与非跨性别男性和女性在人口统计学、行为和临床特征以及支持性服务的需求和未满足需求。
结果:估计有 1.3%的接受美国护理的 HIV 感染者自我认同为跨性别女性。跨性别女性比非跨性别男性和女性在社会经济上更加边缘化。我们发现,接受抗逆转录病毒治疗(ART)的跨性别女性与非跨性别男性和女性的比例没有差异。然而,与非跨性别男性相比,跨性别女性的 ART 完全剂量依从性(78.4%对 87.4%)和持久病毒抑制(50.8%对 61.4%)显著较低。更高比例的跨性别女性需要支持性服务。大多数支持性服务的获得情况没有差异,但跨性别女性比非跨性别男性对食物和住房等基本服务的未满足需求更高。
结论:我们发现跨性别女性与非跨性别者在接受护理、治疗和大多数支持性服务方面几乎没有差异。然而,持久病毒抑制和基本服务未满足需求方面的差异应该进一步探讨。
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