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Fearing drug interactions, transgender women may skip HIV, hormone therapy
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A high proportion of transgender women with HIV who were surveyed said they did not adhere to either ART, feminizing hormone therapy or both for fear of drug interactions, according to researchers.
The findings, concerning a population at high risk for HIV infection, were presented at the International AIDS Society conference in Paris.
“The best thing a person living with HIV can do is to start and stay on safe, effective antiretroviral therapy, both to maintain their own health and to prevent sexual transmission of the virus,” Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), said in a news release. “We need to ensure we understand the perspectives of groups disproportionately affected by this pandemic to provide the best health care for them. Further study is needed to help determine how health care teams can optimally tailor care and treatment for those living with HIV.”
NIAID and the National Institute of Mental Health, both groups under the NIH, supported the study.
Acknowledging a lack of data on ART-hormone therapy interaction, the researchers surveyed 87 transgender women served by a community-based AIDS service organization in Los Angeles. Of those, 69% were undergoing hormone therapy, and 54% had HIV.
A quarter of participants said they used hormone therapy not prescribed by a health care provider, and only 68% said they discussed the potential side effects with health care providers. Among participants with HIV, 34% used hormones not prescribed.
In addition, 57% reported that they were concerned about interactions between ART and hormone therapy, and only 49% said they had discussed those potential interactions with providers. In addition, 40% of participants with HIV said that worries about interactions were reasons for not adhering to ART, hormone therapy or both as directed.
“Despite all indications that transgender women are a critical population in HIV care, very little is known about how to optimize co-administration of ART and hormonal therapies in this population,” study researcher Jordan E. Lake, MD, an infectious diseases and internal medicine specialist at McGovern Medical School in Houston, said in the news release. “This study suggests this void of information may mean some transgender women forego life-sustaining HIV medications, identity-affirming hormone therapy, or some combination of the two. By exploring the extent to which this is happening, we can find ways to better serve this population.” – by Joe Green
Disclosures: Fauci reports no relevant financial disclosures. Lake reports that the study was funded by Gilead Sciences.
Reference:
Braun HM, et al. High levels of treatment non-adherence due to concerns for interactions between antiretroviral therapy and feminizing hormones among transgender women in Los Angeles, CA. Presented at: IAS Conference on HIV Science; July 23-26, 2017; Paris.