CDC MMWR

CDC: Transgender women disproportionately affected by HIV

January 25, 2024

CDC developed a surveillance system called National HIV Behavioral Surveillance Among Transgender Women (NHBS-Trans) to assess behavioral and contextual data through systematic biobehavioral surveillance to monitor behavioral risk factors, prevention usage, and HIV prevalence among transgender women. NHBS-Trans used respondent-driven sampling in seven urban areas in the US: Atlanta, GA; Los Angeles, CA; New Orleans, LA; New York City, NY; Philadelphia, PA; San Francisco, CA; and Seattle, WA. This overview report describes NHBS-Trans 2019–2020 data.

Key takeaways:

• Pre-exposure prophylaxis (PrEP) use among those without HIV was low (32%).
• Four in 10 participants experienced homelessness in the past year.
• Co-occurring conditions—such as homelessness, violence, psychological distress, and incarceration—were associated with behaviors that increase a person’s chances of acquiring HIV.
• Social and economic marginalization led to increased non-prescription use of gender-affirming hormone therapy.
• Employment discrimination negatively impacted access to health insurance and gender-affirming care.
• Experiences of violence and lack of social support contributed to higher levels of suicidal ideation.
• Transgender women might be disproportionately affected by HIV because they experience high levels of social, legal, and economic marginalization, thereby increasing exposure to co-occurring conditions, (e.g., experiencing homelessness, incarceration, exchange sex, polydrug use, violence, and psychological distress).
• Transgender women must remain a priority population in HIV prevention efforts.

Source:

Kanny D, et al. (2024, January 25). CDC MMWR. 73(1);1-8. Overview and Methodology of the National HIV Behavioral Surveillance Among Transgender Women - Seven Urban Areas, United States, 2019-2020. https://www.cdc.gov/mmwr/volumes/73/su/su7301a1.htm