Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.
Stichting hiv monitoring, Amsterdam, The Netherlands.
J Int AIDS Soc. 2024 Aug;27(8):e26317. doi: 10.1002/jia2.26317.
Transgender women are at increased risk of acquiring HIV. Earlier studies reported lower retention in HIV care, antiretroviral therapy uptake, adherence and viral suppression. We assessed the stages of the HIV care continuum of transgender women in the Netherlands over an 11-year period. In addition, we assessed new HIV diagnoses and late presentation, as well as disengagement from care, between 2011 and 2021.
Using data from the Dutch national ATHENA cohort, we separately assessed viral suppression, as well as time to achieving viral suppression, among transgender women for each year between 2011 and 2021. We also assessed trends in new HIV diagnoses and late presentation (CD4 count of <350 cells/µl and/or AIDS at diagnosis), and disengagement from care.
Between 2011 and 2021, a total of 260 transgender women attended at least one HIV clinical visit. Across all years, <90% of transgender women were virally suppressed (207/239 [87%] in 2021). The number of new HIV diagnoses fluctuated for transgender women (p = 0.053) and late presentation was common (ranging between 10% and 67% of new HIV diagnoses). Of the 260 transgender women, 26 (10%) disengaged from care between 2011 and 2021 (incidence rate = 1.10 per 100 person-years, 95% confidence interval = 0.75-1.61).
Between 2011 and 2021, less than 90% of transgender women linked to HIV care were virally suppressed. Late presentation at the time of diagnosis and disengagement from care were common. Efforts are needed to identify barriers to early HIV diagnosis and to optimize the different steps across the care continuum for transgender women.
跨性别女性感染艾滋病毒的风险增加。早期研究报告称，她们在艾滋病毒护理、抗逆转录病毒治疗的接受程度、依从性和病毒抑制方面的保留率较低。我们评估了荷兰跨性别女性在 11 年期间在艾滋病毒护理连续体各个阶段的情况。此外，我们评估了 2011 年至 2021 年期间新的艾滋病毒诊断和晚期就诊以及脱离护理的情况。
利用荷兰国家 ATHENA 队列的数据，我们分别评估了 2011 年至 2021 年期间跨性别女性每年的病毒抑制情况以及达到病毒抑制的时间。我们还评估了新的艾滋病毒诊断和晚期就诊（CD4 计数<350 个细胞/µl 和/或艾滋病诊断）以及脱离护理的趋势。
在 2011 年至 2021 年期间，共有 260 名跨性别女性至少接受过一次艾滋病毒临床就诊。在所有年份中，不到 90%的跨性别女性病毒得到抑制（2021 年为 207/239 [87%]）。跨性别女性新的艾滋病毒诊断数量波动（p=0.053），晚期就诊较为常见（新的艾滋病毒诊断中有 10%至 67%的比例）。在 260 名跨性别女性中，2011 年至 2021 年期间有 26 名（10%）脱离护理（发病率=1.10/100 人年，95%置信区间=0.75-1.61）。
在 2011 年至 2021 年期间，与艾滋病毒护理相关的不到 90%的跨性别女性病毒得到抑制。诊断时晚期就诊和脱离护理较为常见。需要努力识别早期艾滋病毒诊断的障碍，并优化跨性别女性护理连续体的各个步骤。
