Research Activities, March 2014
Transgendered patients with HIV have similar care retention rates as nontransgendered patients
Transgendered individuals with HIV are a unique population when it comes to treatment. They often suffer from discrimination and social isolation. In addition, they and their clinicians may worry about drug-drug interactions between hormone therapy and antiretroviral therapy (ART). As a result, adherence to ART may be problematic. However, a new study offers optimistic findings for this population. AHRQ researcher John A. Fleishman, Ph.D., and colleagues found that, possibly due to advances in ART regimens, transgendered patients were as likely as nontransgender patients to have made two or more primary care visits 90 days or more apart in a calendar year (care retention). In addition, the use of ART was similar for both transgender and nontransgender patients.
The researchers retrospectively studied adults receiving care at 13 HIV clinics across the country participating in the HIV Research Network. They looked at care retention, use of ART, and HIV suppression to less than 400 copies/mL during 1 year. Out of 36,845 patients during the 10-year study period, 285 identified themselves as transgender.
Those who identified as transgender were more likely to be young, Hispanic, and men who had sex with men, compared with nontransgender patients. Retention in care was achieved in 80 percent of patient-years compared to 81 percent for nontransgender men and 81 percent for women. There were similar results for receiving ART: 76 percent for transgender patients compared to 77 percent for nontransgender men and 73 percent for women. The same similarity was found when it came to achieving HIV suppression: 68 percent of transgender patients compared to 69 percent of non-transgender men and 63 percent for women. According to the researchers, advances in HIV therapy, including new drug combinations and simplified dosing, have narrowed the treatment gap and improved health equity in the transgender HIV population.
See "Retention in care and health outcomes of transgender persons living with HIV," by Baligh R. Yehia, M.D., M.P.P., M.S.H.P., Dr. Fleishman, Richard D. Moore, M.D., M.H.S., and Kelly A. Gebo, M.D., M.P.H., in the September 1, 2013, Clinical Infectious Diseases 57, pp. 774-776. Reprints (AHRQ Publication No. 14-R012) are available from AHRQ.