263509 Barriers to Treatment and Service Engagement among Transgender Women Living with HIV in San Francisco

Monday, October 29, 2012 : 10:30 AM - 10:45 AM

Jae Sevelius, PhD , Center of Excellence for Transgender Health, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA
JoAnne Keatley, MSW , Center of Excellence for Transgender Health, University of California, San Francisco, San Francisco, CA
Michael Scarce , Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco
     
Background: Transgender women in California are among the most highly impacted groups in the HIV epidemic to date, yet they are also severely under-researched and underserved by current treatment efforts. The disparities that exist in HIV prevalence, incidence, and adverse health outcomes highlight the need for innovative approaches to understanding and improving health outcomes in this population.

Methods: We conducted four focus groups of HIV+ transwomen in the San Francisco Bay Area, including one in Spanish (N = 42), and 15 individual qualitative interviews regarding participants' experiences of ART treatment regimens, side effects, relationships with providers, and concerns around adherence and retention in care. We interviewed 15 care providers/case managers to explore their perspective on engaging transgender women in care and barriers to adherence. Interviews were digitally recorded, transcribed, and analyzed using template analysis.

Results: Important barriers to treatment engagement and adherence included active substance use, concerns about drug interactions with hormone treatment, concerns about trans-related and HIV-related stigma, and unstable housing. Important service needs included transgender-affirming substance abuse treatment, mental health services, support for transitioning out of incarceration, and dental services.

Conclusion: Interventions to improve health outcomes among transgender women must fully attend to the social, economic, and psychological context of transgender women's lives and address barriers to health care engagement, treatment adherence, and empowerment that serve to create, maintain, and deepen HIV-related health disparities. This data will serve to provide guidance for the development of interventions to improve adherence and treatment engagement among transgender women living with HIV.

Learning Areas:
Diversity and culture

Learning Objectives:
To identify unique challenges to antiretroviral therapy treatment engagement and needs for health services among transgender women living with HIV in San Francisco.

Keywords: HIV/AIDS, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Assistant Professor with the Center for AIDS Prevention Studies (CAPS) at the University of California San Francisco, and Co-Principal Investigator of the Center of Excellence for Transgender Health, which promotes increased access to culturally competent health care for transgender people through research, training, and advocacy. I am the PI on an NIH/NIMH-funded study of HIV risk among transwomen, and two CHRP-funded projects examining HIV prevention and treatment issues among transwomen.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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