Lucas Ruby, Moodley Ruwenne, Garcia Gutiérrez Jessie M, Bambilla Audren J K, Singh Dil, Rogers Hannah, Sherwood Jennifer, Dusic Emerson, Giovenco Danielle, Sun Shufang, Operario Don, Restar Arjee
Epidemiology, University of Washington, Seattle, Washington, USA
Behavioral, Social, and Education Sciences, Emory University, Atlanta, Georgia, USA.
BMJ Open. 2025 Jan 7;15(1):e087821. doi: 10.1136/bmjopen-2024-087821.
Global disparities in HIV prevalence among transgender women are well documented. However, current epidemiological literature on HIV disparities demonstrates gaps in research that include the diversity within transgender populations-for example, transgender men and non-binary trans people across global regions. This systematic review and meta-analysis protocol aims to summarise global HIV inequities among all transgender and non-binary (trans) populations. The objectives of this review are to estimate pooled HIV prevalence and prevention outcomes (pre-exposure prophylaxis and antiretroviral therapy) and differences by gender identity, global regions and self-report versus lab-confirmed findings among trans adults worldwide.
We will conduct a systematic review of all studies on HIV outcomes among trans youth and adults (aged 15+ years) published between 2000 and 2024, following the Preferred Reporting Items for Systematic Review and Meta-Analysis Prereporting guidelines. We will use Covidence software for the title and abstract screening, full-text review and data abstraction processes. We will summarise the study's descriptive statistics and conduct meta-analyses of extracted data points to calculate and synthesise pooled findings and effect size. Specifically, we will use the Mantel-Haenszel method with random effects to model our meta-analyses and the DerSimonian and Laird Q test for heterogeneity testing. We will conduct a narrative synthesis on the areas of research that have been conducted to improve HIV prevention and treatment among trans populations and summarise their findings. Subgroup analyses by gender identity, global regions and self-report versus lab-confirmed findings will be conducted.
Ethics approval is not applicable for this review since we will not be collecting primary data. The results will be disseminated through peer-reviewed publications and conference presentations.
The protocol is registered in the International Prospective Register of Systematic Reviews database (PROSPERO ID: CRD42022357285).
跨性别女性中艾滋病毒流行率的全球差异已有充分记录。然而，当前关于艾滋病毒差异的流行病学文献表明，研究存在差距，其中包括跨性别群体内部的多样性——例如，全球各地区的跨性别男性和非二元性别跨性别者。本系统评价和荟萃分析方案旨在总结所有跨性别和非二元（跨）群体中的全球艾滋病毒不平等情况。本评价的目的是估计全球跨性别成年人中合并的艾滋病毒流行率和预防结果（暴露前预防和抗逆转录病毒治疗），以及按性别认同、全球区域以及自我报告与实验室确诊结果划分的差异。
我们将按照系统评价和荟萃分析预报告指南中的《系统评价和荟萃分析首选报告项目》，对2000年至2024年期间发表的所有关于跨性别青年和成年人（15岁及以上）艾滋病毒结果的研究进行系统评价。我们将使用Covidence软件进行标题和摘要筛选、全文审查以及数据提取过程。我们将总结研究的描述性统计数据，并对提取的数据点进行荟萃分析，以计算和综合汇总结果及效应量。具体而言，我们将使用随机效应的曼特尔 - 亨泽尔方法对荟萃分析进行建模，并使用德西蒙尼安和莱尔德Q检验进行异质性检验。我们将对为改善跨性别群体中的艾滋病毒预防和治疗而开展的研究领域进行叙述性综合，并总结其结果。将按性别认同、全球区域以及自我报告与实验室确诊结果进行亚组分析。
由于我们不会收集原始数据，因此本评价无需伦理批准。研究结果将通过同行评审出版物和会议报告进行传播。
PROSPERO注册号：该方案已在国际系统评价前瞻性注册数据库（PROSPERO ID：CRD42022357285）中注册。
