Abstract
Purpose: This article includes an analysis of medication adherence among transgender and gender nonconforming (TGNC) people living with HIV (PLWH) from the 2015 U.S. Trans Survey (USTS), the largest survey of TGNC people in the United States.Methods: Using data from the USTS, our analytic sample included 162 TGNC PLWH who had been prescribed antiretroviral (ART). We grouped respondents by adherent/nonadherent and compared demographic characteristics and potential adherence risk factors.Results: Approximately 65.8% of participants reported “taking ART as prescribed” all the time (61.0% trans women and 85.7% of trans men). Black TGNC PLWH were more likely to be nonadherent than whites or Hispanics. Adherent participants reported higher rates of home ownership. Nonadherent PLWH reported higher rates of verbal harassment, sex work, and homelessness in the past year, and lower rates of visiting an HIV doctor for care in the past year.Conclusions: USTS respondents living with HIV reported lower adherence than in other nationally representative studies of this population in medical care. HIV rates are higher among black individuals, and reported adherence is lower, suggesting this is a high-priority population. Findings also suggest that unstable sociostructural conditions (homelessness, sex work, etc.) compromise medication adherence. Future practice directions include integrating HIV treatment plans into larger support services for TGNC PLWH.
Highlights
T RANSGENDER AND GENDER NONCONFORMING (TGNC) people are at high risk for HIV infection and in urgent need of HIV prevention and care services.[1,2,3,4,5]
TGNC is an umbrella term for persons whose gender identity, expression, or behavior does not conform to that typically associated with the sex to which they were assigned at birth; including people who identify as transgender and gender nonbinary
Data The 2015 U.S. Trans Survey (USTS) is the largest survey of TGNC people in the U.S Participants (N = 27,715) include people ‡18 years who identified as trans, genderqueer, nonbinary, and other identities on the transgender identity spectrum
Summary
T RANSGENDER AND GENDER NONCONFORMING (TGNC) people are at high risk for HIV infection and in urgent need of HIV prevention and care services.[1,2,3,4,5] TGNC is an umbrella term for persons whose gender identity, expression, or behavior does not conform to that typically associated with the sex to which they were assigned at birth; including people who identify as transgender and gender nonbinary. Many studies we cite represented specific subgroups within the TGNC population, and wherever possible we have tried to use the specific language of the sample of studies referenced.[6] The percentage of transgender people who were diagnosed with HIV in 2015 was three times the national average.[2]. 25% of all transgender women are living with
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