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HIV-positive transgender men in the United States have significant unmet social and health care needs, according to a study published in Research and Practice, AIDSmap reports. Approximately half were living in poverty and only 60 percent had sustained viral suppression.

“Many transgender men receiving HIV medical care in the United States face socioeconomic challenges and suboptimal health outcomes,” write the authors. “Although these transgender men had access to HIV medical care, many experienced poor health outcomes and unmet needs.”

Transgender people experience poorer health outcomes compared to cisgendered individuals, AIDSmap reports.

Little is known about characteristics and outcomes of HIV-positive transgender men (designated female at birth). A team of investigators therefore analyzed the records of patients who received HIV care in the United States between 2009-2014. Their aim was to characterize the sociodemographic and clinical characteristics of these patients, AIDSmap reports.

Overall, transgender men constituted 0.16 percent of all adults but 11 percent of transgender adults receiving HIV care in the United States. The majority (59 percent) were aged between 18-49 years and 40 percent identified as gay or bisexual. Although 42 percent had completed high school, almost half (47 percent) had an income below the national poverty level. A third were uninsured or relied on a Ryan White program for their health care. Over two-thirds (69 percent) had an unmet support need and a quarter were currently living with depression, AIDSmap reports.

Most (53 percent) were sexually active.

The majority (57 percent) had been living with HIV for 10 or more years; a quarter had a history of an AIDS diagnosis. The vast majority (93 percent) had ever taken antiretrovirals; 88 percent were on HIV therapy and 83 percent were fully adherent to their treatment. Last viral load measurement was undetectable in 69 percent and 57 percent had a current CD4 cell count above 500 cells/mm3. Two-thirds of patients had a viral load test every six months but only 40 percent had received sexual health or HIV prevention counseling from a health care professional, AIDSmap reports.

“More than one in 10 transgender persons receiving HIV care were transgender men. HIV-positive transgender men receiving medical care in the United States constitute a small group with socioeconomic challenges, unmet needs for supportive services, and poor (health outcomes),” conclude the authors. “To decrease disparities and achieve health equity among HIV-positive men, HIV care models could incorporate transgender-sensitive health care and mental health services and health insurance inclusive of sex reassignment procedures and physical sex-related care.”