Risk behaviors and HIV care continuum outcomes among criminal justice-involved HIV-infected transgender women and cisgender men: Data from the Seek, Test, Treat, and Retain Harmonization Initiative.
Risk behaviors and HIV care continuum outcomes among criminal justice-involved HIV-infected transgender women and cisgender men: Data from the Seek, Test, Treat, and Retain Harmonization Initiative.
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DOI：
10.1371/journal.pone.0197730
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Biggs ML
中科院分区：
文献类型：
--
作者：
Beckwith CG;Kuo I;Fredericksen RJ;Brinkley-Rubinstein L;Cunningham WE;Springer SA;Loeliger KB;Franks J;Christopoulos K;Lorvick J;Kahana SY;Young R;Seal DW;Zawitz C;Delaney JA;Crane HM;Biggs ML
变性人是高度受害者，被边缘化，不成比例地遭受监禁，与顺性人相比，艾滋病毒感染率令人震惊地增加。很少有研究考察跨性别妇女(TW)，特别是参与刑事司法(CJ)系统的TW的艾滋病毒护理连续结果。为了提高我们对参与CJ系统的HIV感染的TW中HIV护理连续结果和危险行为的理解，我们分析了来自国家药物滥用研究所支持的寻求、测试、治疗、保留(STTR)数据协调倡议的数据。基线数据汇集并分析了三项美国STTR研究，以检验CJ-HIV感染TW与顺性男性(CM)之间的HIV风险和护理连续指标，年龄匹配(在5年内)，研究比例为1：5。88 TW和440 CM被纳入研究。在匹配的参与者中，与CM相比，TW报告吸毒和吸食可卡因的可能性更大(分别为40%，16%，P<；0.001)；TW和CM都报告了较高的无套性行为(分别为58%，%)；TW比CM更有可能有一个以上的性伴侣(OR=2.9，95%CI：1.6，5.2；P<；0.001)，并有过交换性行为(OR=3.9，95%CI：2.3，6.6；P<；0.001)。TW和CM在目前服用ART的百分比(分别为52%和49%)、对ART的平均依从性(两组均为77%)和实现病毒抑制的比例(分别为61%和58%)方面没有显著差异。感染HIV的CJ参与的TW和CM使用ART和病毒抑制相似，但TW比匹配的CM更有可能进行交换性行为，有多个性伴侣，以及使用可卡因/可卡因。TW和CM的无避孕套性行为和使用其他药物的比率同样很高。TW需要量身定制的降低风险干预措施，然而CJ参与的TW和CM都需要集中关注以降低艾滋病毒风险并改善艾滋病毒连续护理结果。
Transgender persons are highly victimized, marginalized, disproportionately experience incarceration, and have alarmingly increased rates of HIV infection compared to cis-gender persons. Few studies have examined the HIV care continuum outcomes among transgender women (TW), particularly TW who are involved with the criminal justice (CJ) system. To improve our understanding of HIV care continuum outcomes and risk behaviors among HIV-infected TW who are involved with the CJ system, we analyzed data from the National Institute on Drug Abuse-supported Seek, Test, Treat, Retain (STTR) Data Harmonization Initiative. Baseline data were pooled and analyzed from three U.S. STTR studies to examine HIV risk and care continuum indicators among CJ-involved HIV-infected TW compared to cisgender men (CM), matched on age (within 5 years) and study at a ratio of 1:5. Eighty-eight TW and 440 CM were included in the study. Among matched participants, TW were more likely to report crack and cocaine use compared to CM (40%,16% respectively, p<0.001); both TW and CM reported high rates of condomless sex (58%, 64%, respectively); TW were more likely than CM to have more than one sexual partner (OR = 2.9, 95% CI: 1.6, 5.2; p<0.001) and have engaged in exchange sex (OR = 3.9, 95% CI: 2.3, 6.6; p<0.001). There were no significant differences between TW and CM in the percentage currently taking ART (52%, 49%, respectively), the mean percent adherence to ART (77% for both groups), and the proportion who achieved viral suppression (61%, 58%, respectively). HIV-infected CJ-involved TW and CM had similar use of ART and viral suppression but TW were more likely than matched CM to engage in exchange sex, have multiple sexual partners, and use crack/cocaine. TW and CM had similarly high rates of condomless sex and use of other drugs. TW require tailored risk reduction interventions, however both CJ-involved TW and CM require focused attention to reduce HIV risk and improve HIV continuum of care outcomes.
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