Four of 10 transgender women have HIV, CDC says

April 16, 2021

A report from the Centers for Disease Control and Prevention (CDC) found that 4 in 10 transgender women surveyed in seven major U.S. cities have HIV, according to a news release from the agency.

The report, one of the most comprehensive surveys of transgender women in the United States to date, also revealed that nearly two-thirds of African American/Black transgender women and more than one-third of Hispanic/Latina transgender women surveyed have HIV.

These findings, released in advance of National Transgender HIV Testing Day, demonstrate the pressing need for scaled-up HIV prevention and care strategies for transgender women, the CDC said, adding that it is actively working to address disparities through strategic program funding and partnerships throughout the nation.

Interviews conducted in 2019 through early 2020 with 1,608 transgender women living in Atlanta, Los Angeles, New Orleans, New York City, Philadelphia, San Francisco, and Seattle found that 42% of respondents with a valid HIV test result had HIV.

The report found stark racial and ethnic differences in HIV rates among respondents. Sixty-two percent of Black transgender women and 35% of Hispanic/Latina transgender women had HIV, compared to 17% of white transgender women. Furthermore, nearly two-thirds of the women surveyed lived at or below the poverty level, and 42% had experienced homelessness in the past 12 months.

The study also examined use of specific prevention services and found that only 32% of participants without HIV reported using pre-exposure prophylaxis (PrEP). PrEP is recommended for people who are at risk of HIV exposure from sex or injection drug use. When taken as prescribed, PrEP is highly effective at preventing HIV.

Previous studies have found that low uptake of PrEP among transgender women may be due to a range of factors, including medical mistrust due to experiences of transphobia, lack of trans-inclusive marketing, and concerns about drug interactions between hormones and PrEP. In this study, 67% of participants without HIV were taking hormones for gender affirmation.

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