Gender-affirming care improves awareness of HIV, STI prevention
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Demolishing social and structural barriers to access to HIV and STI prevention in transgender adolescents of color can come through gender affirmation, according to a presentation of a study at IDWeek.
“Recent CDC data reported the urgent need for more HIV prevention and treatment services in this population,” Michelle Collins-Ogle, MD, FAAP, FPIDS, AAHIVS, said in the presentation. “We assessed key social determinants of health in [transgender or non-binary (TGNB)] youth of color and the impact on their ability to prioritize and access HIV prevention.”
The mean age of patients included in the study was 20 years. Half of patients were transgender female and half were transgender male; 66% of the population were youth of color.
Patients were asked questions regarding the “Four U’s” that present potential barriers to HIV prevention: Unemployed, Uninsured/Underinsured, Unstable housing and substance Use disorder, as well as questions about gender affirmation and HIV/STI prevention.
Gender-affirming care was linked to increased odds of STI testing (adjusted OR = 1.90; 95% CI, 1.33-2.73), with no relation to gender identity.
Among transgender female patients included in the study, 24% initiated PrEP, two seroconverted, one stopped and seven were 70% adherent to treatment with daily oral PrEP.
Among the patients in the study, unemployment was at 23%, unstable housing at 11%, uninsured 10%, and substance use disorder at 40% among participants.
Collins-Ogle and noted that the Bronx has the highest incidence of homelessness and the highest unemployment rate in the country, which peaked at 24.6% during the pandemic.
"Gender-affirming care is associated with access and willingness for STI testing,” Collins-Ogle said. “[Social determinants of health], specifically the four U’s, negatively impact TGNB youth of color in the Bronx and are prioritized over HIV prevention. Further studies are needed to understand the impact of an intervention that assesses their ability to understand risk and improve knowledge gaps within this age gap to improve PrEP uptake in TGNB youth of color.”
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Collins-Ogle M, et al. Transgender adolescents of color and HIV: Unique challenges in preventing new infections. Presented at: IDWeek; Oct. 19-23, 2022; Washington D.C. (hybrid meeting).
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