2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

HIV Estimates: Trans Women

• Baral et al. Global meta-analysis of laboratory-confirmed HIV (2000 – 2011) ▫ Prevalence in US: 22% (OR=34); highest prevalence among trans women of color • Poteat et al. Systematic review and data synthesis (2012 – 2015) ▫ Transfeminine individuals have some of the highest concentrated HIV epidemics in the world with laboratory-confirmed prevalence up to 40%.

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HIV Estimates: Transgender Men

• Systematic review (2012 – 2015); 6 U.S. prevalence studies –1 self-report: 0.4% – 5 laboratory-tested : 0.5% – 4.3% (n=1)

• Possible underestimated high risk for trans men who have sex with men – have not been focus of research or data collection

GreenN, etal. Medicine. 94(41):e1830; Habarta N, etal. Am JPublicHealth. 2015;105:1917-1925; Reisner SL,et al. AIDS Care. 2015;27:1031 – 1036; ReisnerSL, etal. AIDSCare. 2014;26:857-864; Peitzmeier SM, etal. Gen Intern Med. 2014;29:778-784; Feldman J, et al. JHomosex. 2014;61:1558-1588; Poteat TC.CROI 2016,Boston, MA, February 22-25, 2016.Abstract 79.

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Gender Affirmation & HIV Continuum of Care

• Transgender women had lower proportions of retention in care compared to cisgender women and cisgender men, with little change over time. 1 ▫ Transgender women engaged in care had similar proportions of VS • N=400 transgender women in 9 demonstration SPNS sites 2 ▫ 47.5% used hormones within previous 6 months ▫ If HIV primary care provider was hormone prescriber , trans women were 3 times more likely to have VS and to be engaged in care (HIV primary care visit in past 6 mos) • Among transgender women of color living with HIV, gender affirmation and healthcare empowerment significantly and fully mediated the total effect of discrimination on VS.

1. Poteatetal2019 2. DeutschM, etal.2015NHPC.Dec6-9, 2015,AtlantaGA.Abstract1886 3. Seveliusetal2019

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