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Correlates of Engagement in HIV Care Among Transgender Women of Color in the United States of America

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Abstract

HIV prevalence among transgender women of color (TWC) in the United States of America is high. We enrolled TWC living with HIV (N = 858) to evaluate 1nine HIV care interventions. We examined factors associated with four outcomes at enrollment: linkage to care, ever being on antiretroviral treatment, retention in care and viral suppression. The sample was 49% Hispanic/Latino, 42% Black; average age was 37 years; 77% were ever linked to care, 36% were ever on treatment, 22% were retained in care, and 36% were virally suppressed. Current hormone use was significantly associated with linkage, retention, and viral suppression (all aORs > 1.5), providing evidence for gender-affirming care as an important facilitator of engagement in HIV care. Greater health care empowerment was significantly associated with greater odds of all outcomes (aORs between 1.19 and 1.37). These findings identify potential intervention targets to improve the provision of care and treatment for TWC living with HIV.

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Acknowledgements

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U90HA24973 in the amount of $536,244 awarded to the University of California at San Francisco. No percentage of this project was financed with non-governmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. We thank Torsten B. Neilands for his guidance with the analyses. We are grateful to our study participants for their time and for sharing their life experiences with us.

Funding

HRSA, HHS (U90HA24973).

Author information

Authors and Affiliations

  1. Center for AIDS Prevention Studies, Department of Medicine, University of California, UCSF/CAPS, 550 16th Street, 3rd floor, San Francisco, CA, 94158, USA

    Jae M. Sevelius, Deepalika Chakravarty & Greg Rebchook

  2. Center of Excellence for Transgender Health, Department of Medicine, University of California, San Francisco, CA, USA

    Jae M. Sevelius & Greg Rebchook

  3. Silvery Springs, Washington DC, MD, USA

    Jessica Xavier

  4. Innovative Response Globally for Transgender Women and HIV (IRGT), San Francisco, CA, USA

    JoAnne Keatley

  5. Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA

    Starley Shade

Authors
  1. Jae M. Sevelius
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  2. Jessica Xavier
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  3. Deepalika Chakravarty
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  4. JoAnne Keatley
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  5. Starley Shade
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  6. Greg Rebchook
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Consortia

The SPNS Transgender Women of Color Study Group

Contributions

Conceptualization: all authors; Data curation: DC and SS; Formal analysis: DC; Funding acquisition: GR and JK; Methodology: all authors; Writing—original draft: JS, JX, DC; Writing—review & editing: GR, JG. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Jae M. Sevelius.

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Ethical Approval

The study was approved by the local Institutional Review Board at each of the demonstration sites and at the evaluation center.

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All participants provided informed consent prior to participation.

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Sevelius, J.M., Xavier, J., Chakravarty, D. et al. Correlates of Engagement in HIV Care Among Transgender Women of Color in the United States of America. AIDS Behav 25 (Suppl 1), 3–12 (2021). https://doi.org/10.1007/s10461-021-03306-9

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