CDC observes inauguration of National Transgender HIV Testing Day

HIV remains a major health issue for transgender people, particularly transgender women, according to the CDC. A 2013 systematic review showed that HIV was prevalent among 22% of transgender women in the United States, and a separate analysis estimated the prevalence was as high as 56% among transgender women who were black, the CDC reported.

Due to the high risk for HIV in this population, the CDC is joining its partners today to observe the first National Transgender HIV Testing Day. The occasion, sponsored by the Center of Excellence for Transgender Health at the University of California, San Francisco, will focus on expanding HIV testing, prevention and treatment initiatives in the transgender community.

“Transgender people often experience barriers to accessing HIV services because of misperceptions and stigma, lack of knowledge about transgender issues, and social issues such as being underinsured or not having adequate housing or transportation,” Jonathan Mermin, MD, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, and Eugene McCray, MD, director of the CDC’s Division of HIV/AIDS Prevention, wrote in a joint statement. “Eliminating these barriers will help reduce HIV infections among transgender people and provide better care to those living with HIV.”

Jonathan Mermin

Eugene McCray

To mark the occasion, Infectious Disease News has compiled a list of the top five stories covering HIV/AIDS in transgender people.

High HIV burden identified in transgender women

Transgender women comprise a high burden population of HIV worldwide, according to data published in The Lancet Infectious Diseases.

“Transgender women have been either excluded or ignored in most HIV surveillance systems around the world, resulting in a limited understanding of the burden of HIV among this group,” Stefan Baral, MD, MPH, director of the key populations programs in the Center for Public Health and Human Rights at Johns Hopkins School of Public Health, told Infectious Disease News. “However, where studied, transgender women carry among the highest burden of HIV of any population.” Read more.

PrEP protects adhering transgender women from HIV infection

Recent data from the iPrEx trial suggested that pre-exposure prophylaxis treatment may effectively protect transgender women from infection with HIV. Rates of adherence lower than those observed among men who have sex with men, however, appeared to result in no overall reduction in new infections. Read more.

PrEP not associated with increased sexual risk behavior

There was no evidence that receiving pre-exposure prophylaxis, or PrEP, led to increased sexual risk behavior among men who have sex with men and transgender women, according to results from the iPrEx trial.

“PrEP should be discussed with gay men and transgender women who are not using condoms with all partners,” study researcher Robert Grant, MD, MPH, an investigator with Gladstone Institutes, told Infectious Disease News. “Offering PrEP engages people in planning for safer sex.” Read more.

Reduced ART adherence, viral suppression exist among transgender women

Despite similar access to HIV treatments, adherence and durable viral suppression rates among transgender women did not appear to match those of nontransgender persons, according to CDC researchers. Additionally, transgender women were more often socioeconomically marginalized and in need of supportive services covering basic needs such as food and housing. Read more.

VIDEO: Substantial HIV burden in transgender populations

At CROI 2016, Tonia Poteat, PhD, MPH, assistant professor at Johns Hopkins Bloomberg School of Public Health, summarizes her presentation on HIV in transgender populations. Poteat says the burden of HIV in the transgender community is “heavy” as prevention interventions, engagement in care and ART adherence may be impacted by biological factors such as hormone therapies and social factors that include stigma and discrimination. Watch video.