HIV Care Continuum Interventions for Transgender Women: A Topical Review

Author:

Goldhammer Hilary1ORCID,Marc Linda G.12,Psihopaidas Demetrios3,Chavis Nicole S.3ORCID,Massaquoi Massah1,Cahill Sean145,Rebchook Greg6,Reisner Sari1278,Mayer Kenneth A.1289,Cohen Stacy M.3,Keuroghlian Alex S.1810

Affiliation:

1. The Fenway Institute, Fenway Health, Boston, MA, USA

2. Harvard T.H. Chan School of Public Health, Boston, MA, USA

3. HIV/AIDS Bureau, Health Resources and Services Administration, Rockville, MD, USA

4. Boston University School of Public Health, Boston, MA, USA

5. Bouve College of Health Sciences, Northeastern University, Boston, MA, USA

6. Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA

7. Brigham and Women’s Hospital, Boston, MA, USA

8. Harvard Medical School, Boston, MA, USA

9. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

10. Massachusetts General Hospital, Boston, MA, USA

Abstract

Transgender women experience a disproportionate prevalence of HIV and barriers to linkage to care, retention in care, medication adherence, and viral suppression. As part of a national cooperative agreement funded by the Health Resources and Services Administration’s HIV/AIDS Bureau, we searched the literature from January 1, 2010, through June 1, 2020, for English-language articles on interventions designed to improve at least 1 HIV care continuum outcome or address 1 barrier to achieving HIV care continuum outcomes among transgender women diagnosed with HIV in the United States. To be included, articles needed to identify transgender women as a priority population for the intervention. We found 22 interventions, of which 15 reported quantitative or qualitative outcomes and 7 reported study protocols. Recent interventions have incorporated a range of strategies that show promise for addressing pervasive structural and individual barriers rooted in societal and cultural stigma and discrimination against transgender people. Cross-cutting themes found among the interventions included meaningful community participation in the design and implementation of the interventions; culturally affirming programs that serve as a gateway to HIV care and combine gender-affirming care and social services with HIV care; interventions to improve behavioral health outcomes; peer-led counseling, education, and navigation; and technology-based interventions to increase access to care management and online social support. Ongoing studies will further elucidate the efficacy and effectiveness of these interventions, with the goal of reducing disparities in the HIV care continuum and bringing us closer to ending the HIV epidemic among transgender women in the United States.

Funder

U.S. Department of Health and Human Services, Human Resources and Services Administration

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health

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