Antiretroviral Treatment Interruptions Among Black and Latina Transgender Women Living with HIV: Characterizing Co-occurring, Multilevel Factors Using the Gender Affirmation Framework

• DOI: 10.1007/s10461-019-02581-x
• Publication Date: 2019-07-01T10:03:09Z
• Authors: Joseph G. Rosen; Mannat Malik; Erin E. Cooney; Andrea L. Wirtz; Thespina Yamanis; Maren Lujan; Christopher Cannon; David Hardy; Tonia Poteat
• Keywords: Adult; Anti-HIV Agents; Social Stigma; Black People; HIV Infections; Hispanic or Latino; Transgender Persons; Health Services Accessibility; Medication Adherence; 3. Good health; Black or African American; 03 medical and health sciences; 0302 clinical medicine; Anti-Retroviral Agents; 5. Gender equality; Baltimore; District of Columbia; Humans; Female; Healthcare Disparities; Transsexualism

Black and Latina transgender women (BLTW) are disproportionately impacted by HIV but remain underrepresented in HIV and health services research. Between March 2016 and May 2017, BLTW (N = 201) were recruited in Baltimore, Maryland and Washington, DC through convenience sampling for a survey assessing multilevel determinants of HIV risk and treatment outcomes. Interviews concluded with a rapid oral HIV test. Bivariate and multivariable logistic regression modeling was performed to identify gender affirmation-related correlates of self-reported HIV treatment interruptions (HIVTIs) among BLTW living with HIV who had initiated antiretroviral therapy (ART) (n = 96). Among them, 57.3% (n = 55) reported at least one HIVTI. Unmet surgical needs (aOR = 1.6), past-year marijuana use (aOR = 14.6), and no current hormone use (aOR = 24.9) were significantly (p < 0.05) associated with HIVTIs in multivariable analysis. Unmet need for gender affirmation may inhibit ART adherence, highlighting opportunities to mitigate care interruptions in alignment with community needs and goals.