@article{841a6a37b247435d84fc7f6293fd9ced,
title = "Characterizing the Human Immunodeficiency Virus Care Continuum among Transgender Women and Cisgender Women and Men in Clinical Care: A Retrospective Time-series Analysis",
abstract = "Background: Prior studies suggest that transgender women (TW) with human immunodeficiency virus (HIV) are less likely to be virally suppressed than cisgender women (CW) and cisgender men (CM). However, prior data are limited by small sample sizes and cross-sectional designs. We sought to characterize the HIV care continuum comparing TW to CW and CM in the United States and Canada. Methods: We analyzed annual HIV care continuum outcomes by gender status from January 2001 through December 2015 among adults (aged ≥18 years) in 15 clinical cohorts. Outcomes were retention in care and viral suppression. Results: The study population included TW (n = 396), CW (n = 14 094), and CM (n = 101 667). TW had lower proportions retained in care than CW and CM (P <. 01). Estimates of retention in care were consistently lower in TW, with little change over time within each group. TW and CW had similar proportions virally suppressed over time (TW, 36% in 2001 and 80% in 2015; CW, 35% in 2001 and 83% in 2015) and were lower than CM (41% in 2001 and 87% in 2015). These differences did not reach statistical significance after adjusting for age, race, HIV risk group, and cohort. Conclusions: TW experience challenges with retention in HIV care. However, TW who are engaged in care achieve viral suppression that is comparable to that of CW and CM of similar age, race, and HIV risk group. Further research is needed to understand care engagement disparities.",
keywords = "HIV continuum of care, HIV viral suppression, retention in care, transgender women",
author = "Tonia Poteat and Hanna, {David B.} and Rebeiro, {Peter F.} and Marina Klein and Silverberg, {Michael J.} and Eron, {Joseph J.} and Horberg, {Michael A.} and Kitahata, {Mari M.} and Mathews, {W. C.} and Kristin Mattocks and Angel Mayor and Rich, {Ashleigh J.} and Sari Reisner and Jennifer Thorne and Moore, {Richard D.} and Yuezhou Jing and Althoff, {Keri N.}",
note = "Funding Information: Potential conflicts of interest. T. P. has received research funding from Viiv Healthcare and Gilead Sciences. M. K. has received research grants from ViiV Healthcare, Merck, and Gilead and personal fees from ViiV Healthcare, Bristol-Myers Squibb, AbbVie, and Merck. M. J. S. has received research grants from Merck and Gilead. J. J. E. has received personal fees from Merck, research grants and personal fees from Janssen, Gilead Sciences, and ViiV Healthcare. J. T. has received personal fees from Gilead Science. K. N. A. has received personal fees from TrioHealth. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Funding Information: This work was supported by the National Center for Advancing Translational Sciences (KL2TR001077 to T. P.); the NIH (U01AI069918, F31AI124794, F31DA037788, G12MD007583, K01AI093197, K01AI131895, K23EY013707, K24AI065298, K24AI118591, K24DA000432, KL2TR000421, M01RR000052, N01CP01004, N02CP055504, N02CP91027, P30AI027757, P30AI027763, P30AI027767, P30AI036219, P30AI050410, P30AI094189, P30AI110527, P30MH62246, R01AA016893, R01CA165937, R01DA011602, R01DA012568, R01 AG053100, R24AI067039, U01AA013566, U01AA020790, U01AI031834, U01AI034989, U01AI034993, U01AI034994, U01AI035004, U01AI035039, U01AI035040, U01AI035041, U01AI035042, U01AI037613, U01AI037984, U01AI038855, U01AI038858, U01AI042590, U01AI068634, U01AI068636, U01AI069432, U01AI069434, U01AI103390, U01AI103397, U01AI103401, U01AI103408, U01DA03629, U01DA036935, U01HD032632, U10EY008057, U10EY008052, U10EY008067, U24AA020794,U54MD007587, UL1RR024131, UL1TR000004, UL1TR000083, UL1TR000454, UM1AI035043, Z01CP010214, and Z01CP010176); the Centers for Disease Control and Prevention (CDC-200-2006-18797 and CDC-200- 2015-63931); the Agency for Healthcare Research and Quality (90047713), from the Health Resources and Services Administration (90051652); the Canadian Institutes of Health Research (CBR-86906, CBR-94036, HCP-97105, and TGF- 96118); the Ontario Ministry of Health and Long Term Care; and the government of Alberta, Canada. Additional support was provided by the National Cancer Institute, the National Institute for Mental Health, and the National Institute on Drug Abuse. The authors thank Aimee Freeman for her support in project management. Funding Information: Financial support. This work was supported by the National Center for Advancing Translational Sciences (KL2TR001077 to T. P.); the NIH (U01AI069918, F31AI124794, F31DA037788, G12MD007583, K01AI093197, K01AI131895, K23EY013707, K24AI065298, K24AI118591, K24DA000432, KL2TR000421, M01RR000052, N01CP01004, N02CP055504, N02CP91027, P30AI027757, P30AI027763, P30AI027767, P30AI036219, P30AI050410, P30AI094189, P30AI110527, P30MH62246, R01AA016893, R01CA165937, R01DA011602, R01DA012568, R01 AG053100, R24AI067039, U01AA013566, U01AA020790, U01AI031834, U01AI034989, U01AI034993, U01AI034994, U01AI035004, U01AI035039, U01AI035040, U01AI035041, U01AI035042, U01AI037613, U01AI037984, U01AI038855, U01AI038858, U01AI042590, U01AI068634, U01AI068636, U01AI069432, U01AI069434, U01AI103390, U01AI103397, U01AI103401, U01AI103408, U01DA03629, U01DA036935, U01HD032632, U10EY008057, U10EY008052, U10EY008067, U24AA020794,U54MD007587, UL1RR024131, UL1TR000004, UL1TR000083, UL1TR000454, UM1AI035043, Z01CP010214, and Z01CP010176); the Centers for Disease Control and Prevention (CDC-200-2006-18797 and CDC-200-2015-63931); the Agency for Healthcare Research and Quality (90047713), from the Health Resources and Services Administration (90051652); the Canadian Institutes of Health Research (CBR-86906, CBR-94036, HCP-97105, and TGF-96118); the Ontario Ministry of Health and Long Term Care; and the government of Alberta, Canada. Additional support was provided by the National Cancer Institute, the National Institute for Mental Health, and the National Institute on Drug Abuse. Publisher Copyright: {\textcopyright} 2019 The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.",
year = "2020",
month = mar,
day = "3",
doi = "10.1093/cid/ciz322",
language = "English (US)",
volume = "70",
pages = "1131--1138",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "6",
}