Unmet basic needs may be related to low rates of durable viral suppression among female transsexuals with HIV

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P, SeropositivoOrgTrans people, female, living with HIV, are less likely to have excellent adherence to antiretroviral treatment (ART) and a lasting suppression of viral load, compared to other groups, the researchers reported in the online edition of Health LGBT. The study also revealed that many transgender women living with HIV are struggling with the basic needs of life, including food and housing.

The study involved people who received HIV care in the United States.

“Transsexual women in care for HIV were socio-economically more marginalized than male and female“ non-transsexuals ”; a higher percentage of transgender women had lower income, were homeless and had no health insurance, the study authors report.

Transsexual women live with a high risk of contracting HIV. In the USA, HIV prevalence among trans women is increased to 28% and, globally, it is estimated, about one fifth of transsexual women live with HIV.

There are concerns that transgender women are less likely to be involved in HIV care because of stigma and discrimination. Few studies have explored this issue, however the research that was conducted found that trans women had similar rates of care retention, ART absorption and viral suppression compared to other groups.

Researchers from the Centers for Disease Control and Prevention (CDC) they wanted to further study the characteristics and needs of transgender women living with HIV, this time using population-based data.

Therefore, they examined the information obtained through the medical-outpatient monitoring project - an annual cross-sectional survey of individuals accessing HIV care - between 2009 and 2011. They compared the characteristics and needs of transgender non-male and female transgender women.

Approximately 5700 people participated in the study and 1.3 identified as transgender.

The results showed that many transsexual women have been socially marginalized.

More than 80% of women identified as “nonwhites”And who had an income of less than US20.000 per year. One fifth (twenty percent) reported homelessness and approximately one third did not have health insurance. More than 30% reported use of recreational drugs (sic).

, SeropositivoOrgHowever, transgender women had high levels of ART use, with more than 90% having received antiretroviral treatment in the previous year. Approximately three quarters reported 100% adherence in the previous three days and close to 70% had viral suppression (below 200 copies per cubic milliliter of blood [Translator's Norm: I am amazed at the low effectiveness of viral load tests in the US, this, in Brazil, only one viral load with less than 40 copies of viral RNA per milliliter of blood is considered suppressed in its most recent test, but only 50% had durable suppression (viral load undetectable in all tests in the previous year) ).

Compared to non-transsexual women and men, significantly higher proportions of transsexual women had a low income, were homeless and had no health insurance. Drug use rates were higher among transsexual women when compared to non-transsexual women.

ART absorption rates were similar among transgender and non-male Trangean women and women. However, transsexual women were less likely to have perfect adherence to treatment (p 0,01) and durable viral suppression (undetectable viral load) (p 0,01).

"These results suggest the need to investigate what happens to transsexual women after ART is prescribed in order to better understand what can interfere with medication adherence and long-term viral suppression," comment the researchers.

"One possibility is a residual need for support services since transgender women are more likely to be marginalized socio-economically."

Transsexual women, in fact, had a higher reception rate for support services, including case management (71 vs. 61), adherence support (28 versus 20), prevention and counseling (50 vs 39), mental health services ( 46 versus 32) and domestic violence services (4 vs 2).

Significantly higher proportions of transgender women had unmet needs for food (13 vs 7) and housing (13 vs 7). {Editor's note. In good Portuguese they are hungry and “live walking”.}

"The remarkable disparities in durable viral suppression and unmet needs for basic services must be explored further," conclude the researchers. "CDC will monitor progress with the goal of reducing health disparities between transgender people living with HIV."

By Michael Carter Published: July 3, 2015 Translated by Cláudio Souza from the original in Unmet basic needs may be related to poor rates of viral suppression durable Among transgender women with HIV.

, SeropositivoOrg

It is not necessary to be Transsexual or Transvestite to fight Transphobia, nor is it necessary to be black in order to fight against racism ... Nor is it necessary to be HIV positive to fight for the cause of HIV positive people. Engage in this fight!

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Editor's Note:

I have had several conversations with Natasha Roxy, who, incidentally, has been a little disappeared and, besides not giving the air of her grace, she does not write for the Trans and LGBT community to which she is more accessible and, naturally, due to the greater understanding she has on a topic where I would be like a blind man trying to define the blue of the sky to another blind man…. However, this text fell into my lap and I saw that there is an even more abandoned “sector” within the “trans segment” which is that of trans women. And… let's face it. Despite the “achievements”, it is very difficult to be a woman here in Brazil. Flirting, bullying, sexual harassment, unscrupulous employers who announce that they need to hire employees but include the discretionary condition: "Good-looking."

This, for me, is already a revealing factor of third intentions: to employ poorly, to pay less, and to try to possess sexually, for good or ill. If this is already difficult for a woman called "normal" how will things be when you are black, transsexual and poor. Add to that a positive HIV serology and that's done. Because, with the due respect that I must show regarding health professionals like Dr. Sigrid Souza, responsible for Infectology at a University whose city escapes my memory, or “my doctor” Dr. Naomi, who, in times when my health she was more delicate, she stepped down, took off her stethoscope, took cotton, tape and gauze to make an important dressing on my abdomen, or even nurse Camila, who, on one occasion, given my temporary fragility, acted against more than 50 people and passed me by in the collection of exams, and many others, that I would not finish writing if I were to name them all and describe their greatness as professionals and human beings, there is a lot of Health professionals who have prejudice and serve with prejudice , this is very true and poor of these girls, living these situations.

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