Optimizing HIV prevention and care for transgender adults

Lake, Jordan E.; Clark, Jesse L

doi:10.1097/qad.0000000000002095

Cited by 17 publications

(8 citation statements)

References 143 publications

(157 reference statements)

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“…Echoing previous reviews and conceptual papers on transgender health [3–5,12–28,46,54,55], we suggest the following recommendations to move from trans‐subsumed to trans‐centred research: Include transgender people as participants in research . It is frequently argued that transgender populations are too small for inclusion in HIV prevention trans‐centred research.…”

Section: Resultsmentioning

confidence: 99%

“…Echoing previous reviews and conceptual papers on transgender health [3][4][5][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]46,54,55], we suggest the following recommendations to move from trans-subsumed to transcentred research:…”

Section: Recommendations For Future Hiv Prevention Researchmentioning

confidence: 98%

“…We We did not impose any limitations regarding geographical location or language, but searches were conducted in English only. To locate additional relevant publications not identified during the database searches, we examined the reference lists of published reviews and conceptual papers in the field [3][4][5][6][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][33][34][35][36], and used Web of Science's citation tracking to find articles that had cited those reviews and conceptual papers. We conducted an initial search on March 2018, and then updated the search on April 2021 to include articles published until 31 December 2020.…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

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Global scoping review of HIV prevention research with transgender people: Transcending from trans‐subsumed to trans‐centred research

et al. 2021

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Introduction: Globally, transgender populations are disproportionally impacted by HIV and effective HIV prevention interventions targeting these populations are critically needed. Such interventions require research focused on the specific needs and experiences of transgender people. This methodological review aims to determine the extent to which HIV prevention research has included transgender participants by subsuming them into non-transgender populations, or by centring them either in comparison with other groups or as the sole focus of research. Methods: We searched five electronic databases (e.g. SCOPUS) for empirical studies that focused on HIV prevention and included transgender participants, published through 31 December 2020. For each study, we extracted information on: (a) types of inclusion of transgender participants; (b) total sample size and number/percentage of transgender participants; (c) country(ies) where study was conducted; (d) HIV research topics; (e) methods (i.e. quantitative, qualitative or mixed-methods research) and (f) gender identity of transgender participants. Results and discussion: Of 667 HIV prevention studies included in the review, 38.5% subsumed transgender participants into cisgender populations (most frequently combining transgender women with cisgender men who have sex with men), 20.4% compared transgender and cisgender participants and 41.1% focused exclusively on transgender populations. Our global scoping review also revealed that these three types of transgender inclusion in HIV prevention research vary greatly over time, place and thematic areas. Transgender women are the focus of the majority of reviewed studies, whereas transgender men and gender expansive people are rarely included as participants. Conclusions: Inclusion of transgender persons as participants in HIV prevention research has significantly increased, particularly in the last decade. Further research centred on transgender participants and their experiences are needed to develop effective HIV prevention interventions for transgender populations. We advocate for HIV prevention research to move from subsuming transgender people, to trans-centred research that asks questions that focus on their specific needs and experiences. We provide recommendations to move from trans-subsumed to trans-centred HIV prevention research.

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Section: Resultsmentioning

confidence: 99%

Section: Recommendations For Future Hiv Prevention Researchmentioning

confidence: 98%

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

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Global scoping review of HIV prevention research with transgender people: Transcending from trans‐subsumed to trans‐centred research

et al. 2021

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“…Therefore, we must improve management of this public health issue by eliminating administrative and social barriers and the stigma associated with health care in this population. In our study, we observed that NGOs will continue to play a major role both in the diagnosis of new cases of HIV infection and in facilitating referral to health centers 19 and providing appropriate access to care for all patients. Structured collaboration between administrative institutions, health care centers, and NGOs is mandatory.…”

Section: Discussionmentioning

confidence: 92%

Health care issues affecting transgender people living with HIV: an opportunity for improvement

et al. 2020

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The high vulnerability of transgender (TG) persons to HIV infection and the difficulties associated with access to health services can lead to delays in the diagnosis and treatment of HIV infection, thus increasing the risk of transmission of HIV by this population. We performed a retrospective study to analyze the main characteristics of TG living with HIV infection in a hospital in Madrid, Spain and to identify issues related to lack of access to the health care system and combination antiretroviral therapy (cART). We analyzed 28 TG, of whom 22 (78.6%) were TG women. Median age was 28 years (interquartile range [IQR]: 29–45), 24 (85.7%) were Latin American (all of them without health insurance), and 12 (42.8%) were sex workers. Accessibility to the health system was more difficult for 22 (78.6%) of foreign-born TG people living with HIV, with a median delay to initiation of cART of six months (IQR: 2–24). These values were greater than those recorded for the control group comprising other people living with HIV (16.9% and one month, respectively). At the first access to health care in our hospital, CD4+ cell count and HIV viral load (VL) were worse in TG patients, with a median baseline CD4+ cell count below 350 cells/µl and a higher median HIV VL, both in naïve patients (28.6%) and in pre-treated patients whose therapy was interrupted owing to access-related issues (46.4%). These data show high vulnerability to HIV infection among TG and highlight that issues associated with access to health care can cause delays in the diagnosis and treatment of HIV infection. Based on our results, we think that the health care system should adapt to the sociodemographic, clinical, and behavioral characteristics of TG people living with HIV and develop specific, targeted preventive programs to address the vulnerability of this group.

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“…Studies that have evaluated physical health disparities that exist among transgender adults have found increased risk of cardiovascular disease among transgender adults [8,9]. Most of these studies have focused on HIV [10][11][12], substance use [13][14][15], and hormone use [16][17][18][19] without significant emphasis on specific vascular disease mechanisms and outcomes. Many of these risk factors may also lead to increased risk for cerebrovascular disease.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis, Treatment, and Prevention of Stroke in Transgender Adults

Diaz

Rosendale

2022

Curr Treat Options Neurol

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Purpose of Review To identify the current state of science on stroke in transgender adults and highlight gaps in need of further research. We will review current research on cerebrovascular risk and disease, hormone therapy, and stroke in transgender individuals. Finally, we will provide a framework for healthcare providers to prevent and reduce disparities through inclusive care practices. Recent Findings Transgender people experience unique stroke risk factors, secondary to both psychosocial stress and health-related behaviors. These include higher rates of HIV, tobacco use, stimulant use, and hepatitis C. The use of gender-affirming hormone therapy may lead to an increased risk for ischemic stroke, but the data are limited and require further research. Summary Recent research has highlighted the numerous healthcare disparities faced by transgender individuals. Regarding stroke disparities, these are multifactorial and include contributions from health-related behaviors, inadequate access to care, the use of hormonal therapy, and minority stress. Further research is needed to increase access to care and reduce the substantial gap in outcomes for these individuals.

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Optimizing HIV prevention and care for transgender adults

Cited by 17 publications

References 143 publications

Global scoping review of HIV prevention research with transgender people: Transcending from trans‐subsumed to trans‐centred research

Global scoping review of HIV prevention research with transgender people: Transcending from trans‐subsumed to trans‐centred research

Health care issues affecting transgender people living with HIV: an opportunity for improvement

Diagnosis, Treatment, and Prevention of Stroke in Transgender Adults

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