Baguso Glenda N, Gay Caryl L, Lee Kathryn A
a Department of Community Health Systems , University of California , San Francisco , CA , USA.
b Department of Family Health Care Nursing , University of California , San Francisco , CA , USA.
AIDS Care. 2016 Aug;28(8):976-81. doi: 10.1080/09540121.2016.1146401. Epub 2016 Feb 24.
Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the US report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore the factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transgender women. This secondary analysis is based on data collected from the Symptom and Genetic Study that included a convenience sample of 22 self-identified transgender women, 201 non-transgender men, and 72 non-transgender women recruited in northern California. Self-reported medication adherence was assessed using the AIDS Clinical Trials Group Adherence Questionnaire. Gender differences in demographic and clinical variables were assessed, as were differences between transgender women reporting high and low adherence. Transgender women had lower adherence to medications compared to non-transgender males and non-transgender females (p = .028) and were less likely to achieve viral suppression (p = .039). Within the transgender group, Black/African-Americans reported better adherence than participants who were Whites/Caucasian or other races (p = .009). Adherence among transgender women was unrelated to medication count and estrogen therapy, but consistent with other reports on the HIV population as a whole; transgender women with high adherence were more likely to achieve viral suppression compared to the transgender women with low adherence. Despite the high incidence of HIV infection in the transgender population, few studies focus on TWLWH, either in regard to their adherence to antiretroviral therapies or to their healthcare in general. To address ongoing health disparities, more studies are needed focusing on the transgender population's continuum of care in HIV therapies.
药物依从性与感染艾滋病毒的成年人的健康结果相关。美国感染艾滋病毒的跨性别女性（TWLWH）报告称其药物依从性欠佳，且发现她们在将艾滋病毒药物融入日常生活方面存在困难，但很少有研究探讨与跨性别女性药物依从性相关的因素。因此，本文的目的是研究与跨性别女性自我报告的药物依从性相关的人口统计学和临床因素。这项二次分析基于从症状与基因研究中收集的数据，该研究纳入了在加利福尼亚州北部招募的22名自我认定的跨性别女性、201名非跨性别男性和72名非跨性别女性的便利样本。使用艾滋病临床试验组依从性问卷评估自我报告的药物依从性。评估了人口统计学和临床变量中的性别差异，以及报告高依从性和低依从性的跨性别女性之间的差异。与非跨性别男性和非跨性别女性相比，跨性别女性的药物依从性较低（p = 0.028），且实现病毒抑制的可能性较小（p = 0.039）。在跨性别群体中，黑人/非裔美国人报告的依从性优于白人/高加索人或其他种族的参与者（p = 0.009）。跨性别女性的依从性与药物数量和雌激素治疗无关，但与关于整个艾滋病毒人群的其他报告一致；与低依从性的跨性别女性相比，高依从性的跨性别女性更有可能实现病毒抑制。尽管跨性别群体中艾滋病毒感染率很高，但很少有研究关注感染艾滋病毒的跨性别女性，无论是在她们对抗逆转录病毒疗法的依从性方面，还是在她们总体的医疗保健方面。为了解决持续存在的健康差距，需要更多关注跨性别群体在艾滋病毒治疗方面连续护理的研究。
