Division of General Pediatrics, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
AIDS Behav. 2017 Dec;21(12):3312-3327. doi: 10.1007/s10461-017-1938-8.
In the U.S., transgender and other gender minority (TG) youth are an at-risk group understudied in HIV prevention and treatment. This study sought to characterize the HIV prevention and care continua in a diverse sample of 181 sexually-active TG ages 16-24 years (mean age = 20.7 years; 76.8% trans feminine; 69.1% youth of color) recruited July-December 2015 in 14 U.S. cities. Overall, 30.9% reported living with HIV, of which 71.4% were on antiretroviral therapy (ART) and 55.0% were medication adherent; 65.6% were known to be virally suppressed. In multivariable models, medical gender affirmation was associated with lower odds of viral suppression. Medical gender affirmation and stigma in HIV care were each independently associated with elevated odds of having missed HIV care appointments. Among at-risk TG youth not living with HIV, only 8.2% had accessed pre-exposure prophylaxis (PrEP). Early biobehavioral prevention and treatment interventions are needed for TG youth.
在美国，跨性别和其他性别少数群体（TG）青年是 HIV 预防和治疗中研究不足的高危群体。本研究旨在描述在 2015 年 7 月至 12 月在美国 14 个城市招募的 181 名 16-24 岁的活跃性 TG 青年（平均年龄 20.7 岁；76.8%的人是跨女性化；69.1%的人是有色人种）的多样化样本中的 HIV 预防和护理连续性。总体而言，30.9%的人报告感染了 HIV，其中 71.4%的人正在接受抗逆转录病毒治疗（ART），55.0%的人是药物依从者；65.6%的人病毒载量得到了抑制。在多变量模型中，医学性别肯定与较低的病毒抑制几率相关。在 HIV 护理中的医学性别肯定和耻辱感与错过 HIV 护理预约的几率增加有关。在未感染 HIV 的高危 TG 青年中，只有 8.2%的人接受过暴露前预防（PrEP）。需要针对 TG 青年开展早期的生物行为预防和治疗干预措施。
