Socio-ecological Barriers to Viral Suppression Among Transgender Women Living with HIV in San Francisco and Los Angeles, California

被引:5
作者
Jain, Jennifer P. [1 ]
Hill, Miranda [2 ]
Gamarel, Kristi E. [3 ]
Santos, Glenn-Milo [1 ]
Johnson, Mallory O. [2 ]
Neilands, Torsten B. [2 ]
Dilworth, Samantha E. [2 ]
Reback, Cathy J. [4 ,5 ]
Sevelius, Jae [2 ,6 ]
机构
[1] Univ Calif San Francisco, Dept Community Hlth Syst, 2 Koret Way, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Dept Med, San Francisco, CA USA
[3] Univ Michigan, Dept Hlth Behav & Hlth Educ, Sch Publ Hlth, Ann Arbor, MI USA
[4] Friends Res Inst, Los Angeles, CA USA
[5] Univ Calif Los Angeles, Ctr HIV Identificat Prevent & Treatment Serv, Los Angeles, CA USA
[6] Columbia Univ, Dept Psychiat, New York, NY USA
关键词
Transgender women; HIV; Viral suppression; Sex work; Homelessness; Drug use; FEMALE SEX WORKERS; CARE CASCADE; DRUG-USE; PREVENTION; RISK; ENGAGEMENT; DEPRESSION; RETENTION; HIV/AIDS; OUTCOMES;
D O I
10.1007/s10461-023-03979-4
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Troubling disparities in viral suppression persist among transgender (trans) women living with HIV in the US. We utilized baseline data from a randomized controlled trial of a behavioral intervention among trans women living with HIV in San Francisco and Los Angeles, to identify the socio-ecological correlates of biologically confirmed viral suppression (< 200 HIV-1 RNA copies/mL). Among 253 participants, the mean age was 43 (SD = 11), 46% identified as Black or African American and 35% were virally non-suppressed. In adjusted Poisson regression models, the following barriers to viral suppression were identified: injection drug use [adjusted risk ratio (aRR) 0.78, 95% CI 0.65-0.93, Z = - 2.64, p = 0.008], methamphetamine use (aRR 0.65, 95% CI 0.51-0.83, Z = - 3.45, p = 0.001), amphetamine use (aRR 0.62, 95% CI 0.44-0.87, Z = - 2.75, p = 0.006), homelessness (aRR 0.79, 95% CI 0.63-0.98, Z = - 2.06, p = 0.039), and sex work (aRR 0.60, 95% CI 0.41-0.86, Z = - 2.77, p = 0.009). These findings underscore the importance of interventions that address the socio-ecological barriers to viral suppression among trans women in urban settings.
引用
收藏
页码:2523 / 2534
页数:12
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