Interventions that address the important needs of HIV-positive transgender women of color are associated with improved rates of viral suppression.
Researchers studied outcomes among nearly 700 such women who participated in an initiative to provide them with screening, referrals and various services in Chicago, Los Angeles, New York and the San Francisco Bay Area. Most were Latina or Black, unemployed and had low incomes.
The goal was to improve the participants’ engagement with and retention in HIV care. When appropriate, the participants received referrals and services for HIV primary care, mental health and substance use treatment, assistance with housing and food, legal advice, and support around education, job training and finding work.
By the study’s two-year mark, the proportion of participants linked to medical care for HIV increased from 45% to 78%, the rate of retention in ongoing care increased from 33% to 40% and the rate of viral suppression increased from 23% to 35%.
After adjusting the data to account for various differences among the study participants, the researchers found that the following factors were associated with a two- to six-fold increased likelihood of achieving viral suppression after 24 months: screening for mental health issues and food insecurity, referral to HIV primary care services, mental health care and food assistance, retention in care counseling and employment assistance.
“Continued efforts to scale up the adoption of these interventions by outpatient HIV clinics that serve transgender women of color are critical to meet national goals for treatment and prevention,” says study author Jessica Xavier, MPH, an independent health consultant who formerly worked for the Health Resources and Services Administration.