Faculdade de Ciências Médicas da Santa Casa de São Paulo. Departamento de Saúde Coletiva. São Paulo, SP, Brasil.
Universidade Católica de Santos. Programa de Pós-Graduação em Saúde Coletiva. Santos, SP, Brasil.
Rev Saude Publica. 2020 Nov 20;54:118. doi: 10.11606/s1518-8787.2020054002374. eCollection 2020.
To examine the HIV care cascade among trans women and travestis in São Paulo - Brazil, the most populous city in South America.
Using data from a cross-sectional study carried out between November 2016 and May 2017 in the city of São Paulo (Divas Research). Respondent driven sampling (RDS) was used to recruit 386 transgender women and travestis who participated in a HIV risk survey and were tested for HIV. The cascade was defined as HIV prevalence, HIV diagnosed, Antiretroviral (ART) Prescription, and currently on ART. A multiple analysis model was conducted to identify the association between sociodemographics and the cascade gaps.
Of the trans women living with HIV, 80.9% were already diagnosed, 76.6% of them had been prescribed, of which 90.3% were currently on treatment. Those who were registered in care had a higher rate of ART (aPR 2.06; 95%CI 1.09-3.88). Trans women between 31-40 years old (aPR 1.65; 95%CI 1.09-2.50) and those older than 40 (aPR 1.59; 95%CI 1.04-2.43) had higher prevalence of ART.
Our data suggest an increase in the testing and treatment policy implementation among trans women in the city of São Paulo, although gaps have been found in the linkage to care. However, young trans women and those not registered in health care service may benefit from efforts to engage this part of the population in care to improve HIV treatment and care outcomes.
研究巴西圣保罗市跨性别女性和变装者的艾滋病毒护理链，该城市是南美洲人口最多的城市。
使用 2016 年 11 月至 2017 年 5 月在圣保罗市（Divas 研究）进行的一项横断面研究的数据。采用 respondent driven sampling（RDS）招募了 386 名参加艾滋病毒风险调查并接受艾滋病毒检测的跨性别女性和变装者。该护理链被定义为艾滋病毒流行率、艾滋病毒诊断、抗逆转录病毒治疗（ART）处方和目前正在接受 ART 治疗。采用多因素分析模型来确定社会人口统计学特征与护理链差距之间的关联。
在感染艾滋病毒的跨性别女性中，80.9%已经被诊断，其中 76.6%已经被处方治疗，其中 90.3%目前正在接受治疗。那些在护理中登记的人接受 ART 的比例更高（调整后的比值比 2.06；95%CI 1.09-3.88）。年龄在 31-40 岁之间的跨性别女性（调整后的比值比 1.65；95%CI 1.09-2.50）和年龄超过 40 岁的跨性别女性（调整后的比值比 1.59；95%CI 1.04-2.43）接受 ART 的比例更高。
我们的数据表明，在圣保罗市，跨性别女性的检测和治疗政策实施有所增加，尽管在获得护理方面仍存在差距。然而，年轻的跨性别女性和未在医疗保健服务中登记的女性可能受益于努力让这部分人群参与护理，以改善艾滋病毒治疗和护理的结果。
