Year: 2022
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Describe engagement in HIV care over time after initial engagement in HIV care, by gender identity. DESIGN: Observational, clinical cohort study of people with HIV engaged in routine HIV care across the United States. METHODS: We followed people with HIV who linked to and engaged in clinical care (attending ≥2 visits in 12 months) in cohorts in the North American Transgender Cohort Collaboration, 2000-2018. Within strata of gender identity, we estimated the 7-year (84-month) restricted mean time spent: lost-to-clinic (stratified by pre/postantiretroviral therapy (ART) initiation); in care prior to ART initiation; on ART but not virally suppressed; virally suppressed (≤200 copies/ml); or dead (pre/post-ART initiation). RESULTS: Transgender women ( N = 482/101 841) spent an average of 35.5 out of 84 months virally suppressed (this was 30.5 months for cisgender women and 34.4 months for cisgender men). After adjustment for age, race, ethnicity, history of injection drug use, cohort, and calendar year, transgender women were significantly less likely to die than cisgender people. Cisgender women spent more time in care not yet on ART, and less time on ART and virally suppressed, but were less likely to die compared with cisgender men. Other differences were not clinically meaningful. CONCLUSIONS: In this sample, transgender women and cisgender people spent similar amounts of time in care and virally suppressed. Additional efforts to improve retention in care and viral suppression are needed for all people with HIV, regardless of gender identity.
Source: AIDS
Institutions: Johns Hopkins University, University of North Carolina at Chapel Hill, Albert Einstein College of Medicine, Central University of the Caribbean, Kaiser Permanente, Kaiser Permanente Northern California, Vanderbilt University, Vanderbilt University Medical Center, Johns Hopkins Medicine, VA Connecticut Healthcare System, Centers for Disease Control and Prevention, University of Washington, National Institutes of Health, National Cancer Institute
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Government of Alberta, National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration, Agency for Healthcare Research and Quality, Canadian Institutes of Health Research, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Human Genome Research Institute, National Eye Institute, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Nursing Research, National Institute of General Medical Sciences, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, National Institute of Dental and Craniofacial Research, National Center for Research Resources, National Center for Advancing Translational Sciences, National Institute on Minority Health and Health Disparities, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1120543537, Patient-Oriented Research and Mentorship in HIV and Non-Communicable Diseases, G1308370826, G1313295902, G1338033529, G1400602301, G1531094742, G1641903089, Clinical and Translational Science Institute, G1655989834, G1808638082, G183157880, G1841744478, G192128497, G196810821, G198493010, G2088370805, G2118333931, G2127051194, G2146752487, G2358688911, G2368261824, G2403798763, INCIDENCE OF HIV INFECTION IN A COHORT OF IV DRUG USERS, G246083127, G248289952, G248584506, G2490064313, G2516619799, G2611851387, G2661436214, G2744122616, G2755707676, G2759654445, G282275641, G2913193658, Challenging and Expanding Paradigms of Aging with HIV, G3046393879, G3159778318, G319781266, Alcohol and HIV Treatment and Clinical Progression, G3242306066, G3362259045, G340495000, G3421619042, G3443624367, G345309049, G3478320008, G350592738, G354743836, UNC Clinical and Translational Science Award, G3672534956, G37178870, G374818150, G378552126, A Community-Clinic Collaboration to Improve Outcomes in HIV+ Substance Users Released from Jail, G3843789903, G3972873079, G3990922931, G406407855, G4077704838, G4200602080, G4278730511, G483408255, G4840519279, G5062295240, G5122873492, G5197401681, G5238485884, G5268332287, G5275867375, Studies of Ocular Complications of AIDS - Coordinating Center, ADULT ACTG CENTRAL GROUP, G5747858550, UCSD Department of Medicine HIV/AIDS Clinical Trials Unit, G610849472, G6282114380, G6491251069, G650174051, G6508876686, G6521043675, Universities without walls: A CIHR Training Grant in HIV/AIDS Health Research, G678635131, G679121021, HIV Disease Outcomes in Drug Users in Clinical Practice, G693056094, G693265041, G7028447115, University of North Carolina Womens Interagency HIV Study UNC WIHS, G712601197, G721343873, G7297612551, Hispanic Alliance for Clinical and Translational Research (Alliance), G7415795898, G7457594742, G7507413627, Employment and Health Outcomes in HIV/AIDS: A Prospective Mixed Methods Cohort Study, G7652719650, G7803479958, G8080593942, G81379742, G83548117, G8556153269, Positive Spaces, Healthy Places - Phase IV: Monitoring and Evaluation to Understand the Health Effects of Housing Status in HIV/AIDS, G8741768013, G8835711225, Alcohol Associated Outcomes Among HIV+/-Aging Veterans, G8901597276, G9000000445, G9000002775, G9000007952, G9000010044, G9000011576, G9000025681, G9000030772, G9000039283, G9000040447, G9000046174, G9000048118, G9000048796, G9000049992, G9000050451, G9000066220, G9000066970, G9000072212, G9000074434, Tennessee Center for AIDS Research (TN-CFAR), G9000079326, G9000081321, G9000082407, G9000093720, G9000095569, G9000102070, G9000108801, G9000126122, G9000126231, G9000132212, G9000156273, G9000160247, G9000189727, G9000211873, G9000244682, AIDS Linked to the IntraVenous Experience (ALIVE) Study, Rustbelt Center for AIDS Research (Case/UHC-Pitt CFAR), The Johns Hopkins Center for AIDS Research (JHU CFAR), North American AIDS Cohorts on Collaboration and Design (NAACCORD), UNC MACS/WIHS Combined Cohort Study Clinical Research Site, Surviving the HIV Epidemic (S/HE) in metropolitan Washington DC - Advancing knowledge through cohort studies, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS), UAB Center for AIDS Research (CFAR), G909612408, G932371335, G97119092, G995521847
OpenAlex ID: W4287448118