Characterizing disparities in the HIV care continuum among U.S. transgender and cisgender medicare beneficiaries, 2008–2017

AIDS Care, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 12

Published: Jan. 31, 2025

Although HIV is more prevalent among transgender and gender-diverse individuals than cisgender people, a dearth of research has compared the HIV-related care engagement these populations. Using 2008-2017 Medicare data, we identified TGD (trans feminine non-binary [TFN], trans masculine [TMN], unclassified gender) (male, female) beneficiaries with explored within between gender group differences in predicted probability Care Continuum. Transgender had higher every outcome vs. individuals, TFN showing highest visit engagement, sexually transmitted infection screening, antiretroviral treatment receipt persistence. Notably, except for females TMN people slightly lower engaging males. living better Continuum findings highlight disparities females, though was still low beneficiariesof all genders. Interventions are needed to reduce barriers beneficiaries.

Language: Английский

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Leveraging Bundled Interventions to Address Intersectional Barriers to Care for Black Women With HIV, the Black Women First Initiative, 2020

American Journal of Public Health, Journal Year: 2025, Volume and Issue: 115(S1), P. S68 - S74

Published: March 26, 2025

The 2020 initiative Improving Care and Treatment Coordination: Focusing on Black Women With HIV funded by the US Department of Health Human Services Office Assistant Secretary for Health’s Minority HIV/AIDS Fund Resources Administration’s Bureau Ryan White Program aimed to enhance health well-being cisgender transgender women with through bundled interventions at 12 sites. initiative’s intersectional approach involved in program development implementation. Quantitative data from 743 participants highlighted disparities employment housing, emphasizing need holistic, culturally sensitive care. In quantitative responses, participants, regardless gender identity, reported HIV-related stigma racial discrimination, qualitatively reporting additional gender-based inequities that affect their outcomes quality life. We summarize findings provide recommendations address barriers care improve among HIV. Results this suggest a flexible, responsive system emphasizes broad service delivery model reflecting participants’ diverse identities can outcomes. ( Am J Public Health. 2025;115(S1):S68–S74. https://doi.org/10.2105/AJPH.2025.308022 )

Language: Английский

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Characterizing Disparities in the HIV Care Continuum among Transgender and Cisgender Medicare Beneficiaries

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: March 20, 2024

ABSTRACT Background In the US, transgender and gender-diverse (TGD) individuals, particularly trans feminine experience a disproportionately high burden of HIV relative to their cisgender counterparts. While engagement in Care Continuum (e.g., care visits, antiretroviral (ART) prescribed, ART adherence) is essential reduce viral load, transmission, related morbidity, extent which TGD people engage one or more steps at similar levels as understudied on national level by gendered subgroups. Methods Findings We used Medicare Fee-for-Service claims data from 2009 2017 identify (trans non-binary (TFN), masculine (TMN), unclassified gender) (male, female) beneficiaries with HIV. Using retrospective cross-sectional design, we explored within- between-gender group differences predicted probability (PP) engaging Continuum. individuals had higher every outcome compared [HIV Visits: PP=0.22, 95% Confidence Intervals (CI)=0.22-0.24; PP=0.21, CI=0.21-0.22); Sexually Transmitted Infection (STI) Screening (TGD PP=0.12, CI=0.11-0.12; PP=0.09, CI=0.09-0.10); Prescribed PP=0.61, CI=0.59-0.63; PP=0.52, CI=0.52-0.54); Persistence adherence (90% persistence: PP=0.27, CI=0.25-0.28; PP=0.13, CI=0.12-0.14; 90% PP=0.23, CI=0.22-0.23; PP=0.11, CI=0.11-0.12)]. Notably, TFN highest (HIV Visits PP =0.25, CI=0.24-0.27; STI =0.22, CI=0.21-0.24; PP=0.71, CI=0.69-0.74; PP=0.30, CI=0.28-0.32; PP=0.15, CI=0.14-0.16) TMN females lowest =0.18, CI=0.14-0.22; Screening: Cisgender Female =0.11, Receipt: PP=0.40, CI=0.39-0.42; Persistence: CI=0.11-0.20; PP=0.07, CI=0.04-0.10). The main limitation this research that were included based observed care, whereas who did not access relevant through any point during study period included. Thus, our findings may be generalizable all HIV, including those Advantage other types insurance. Conclusions Although living superior than highlight notable disparities for females, was still low beneficiaries, independent gender. Interventions are needed barriers improve treatment outcomes HIV-related morbidity mortality US.

Language: Английский

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Transgender Latinas’ Perspectives on HIV PrEP Uptake, Condom Use, and Medically Supervised Gender-Affirming Hormone Therapy: Insights From ChiCAS Qualitative Interviews

AIDS Education and Prevention, Journal Year: 2024, Volume and Issue: 36(5), P. 369 - 386

Published: Oct. 1, 2024

There is a dearth of HIV prevention behavioral interventions for transgender Latinas, despite this population's risk. ChiCAS (Chicas Creando Acceso la Salud) an intervention to increase PrEP, condom, and gender-affirming hormone therapy (GAHT) use among Latinas. To inform future work, semistructured interviews were conducted postintervention with 28 participants. Thematic analysis inductive coding was used. Six themes emerged: (1) health-related priorities include sexual health avoiding discrimination; (2) safe collaborative community high importance; (3) interactive education time sharing stories discussion valued; (4) PrEP uptake facilitated through awareness care navigation; (5) accessing GAHT depends on cost, clinic location, individual goals; (6) could be improved more PrEP/GAHT details social connection. Interventions goals similar those should prioritize building community, tailored participants' needs, emphasize options available locally.

Language: Английский

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