Department of Social Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, 27599-7240, USA.
Department of Medicine, New York University School of Medicine, New York, NY, USA.
Drugs. 2020 Jul;80(10):965-972. doi: 10.1007/s40265-020-01313-z.
HIV prevalence is elevated among transgender populations with an estimated 13.7% of transgender adults living with HIV in the USA. In addition, transgender people experience significant disparities in biomedical HIV prevention and treatment. The efficacy of topical microbicides for prevention of HIV acquisition have not been tested among transgender people and may be impacted by hormonal therapies and/or surgeries undertaken by some transgender people to align their anatomy with their gender identity. Low pre-exposure prophylaxis (PrEP) uptake and adherence as well as potential drug-hormone interactions impact the efficacy of PrEP among transgender women. Few transgender men have been engaged in the PrEP continuum, and they have been largely excluded from PrEP research until very recently. Prioritisation of hormone therapy over HIV treatment as well as concerns about drug-hormone interactions may impact transgender women's adherence to antiretroviral therapy. More research is needed to clarify the clinical significance of identified drug-hormone interactions and better inform interventions to improve HIV prevention and care for transgender people.
HIV 在跨性别群体中的流行率较高，据估计，美国有 13.7%的跨性别成年人感染 HIV。此外，跨性别者在生物医学 HIV 预防和治疗方面存在显著差异。局部杀微生物剂预防 HIV 感染的效果尚未在跨性别者中进行测试，并且可能会受到一些跨性别者为使其解剖结构与性别认同一致而接受的激素治疗和/或手术的影响。低暴露前预防 (PrEP) 的使用率和依从性以及潜在的药物-激素相互作用影响了 PrEP 在跨性别女性中的效果。很少有跨性别男性参与 PrEP 连续体，直到最近，他们才在很大程度上被排除在 PrEP 研究之外。将激素治疗置于 HIV 治疗之前，以及对药物-激素相互作用的担忧，可能会影响跨性别女性对抗逆转录病毒治疗的依从性。需要进一步的研究来阐明已确定的药物-激素相互作用的临床意义，并更好地为改善跨性别者的 HIV 预防和护理提供干预措施。
