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© 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Introduction

Transgender women are at increased risk of acquiring HIV. Earlier studies reported lower retention in HIV care, antiretroviral therapy uptake, adherence and viral suppression. We assessed the stages of the HIV care continuum of transgender women in the Netherlands over an 11‐year period. In addition, we assessed new HIV diagnoses and late presentation, as well as disengagement from care, between 2011 and 2021.

Methods

Using data from the Dutch national ATHENA cohort, we separately assessed viral suppression, as well as time to achieving viral suppression, among transgender women for each year between 2011 and 2021. We also assessed trends in new HIV diagnoses and late presentation (CD4 count of <350 cells/µl and/or AIDS at diagnosis), and disengagement from care.

Results

Between 2011 and 2021, a total of 260 transgender women attended at least one HIV clinical visit. Across all years, <90% of transgender women were virally suppressed (207/239 [87%] in 2021). The number of new HIV diagnoses fluctuated for transgender women (ptrend = 0.053) and late presentation was common (ranging between 10% and 67% of new HIV diagnoses). Of the 260 transgender women, 26 (10%) disengaged from care between 2011 and 2021 (incidence rate = 1.10 per 100 person‐years, 95% confidence interval = 0.75−1.61).

Conclusions

Between 2011 and 2021, less than 90% of transgender women linked to HIV care were virally suppressed. Late presentation at the time of diagnosis and disengagement from care were common. Efforts are needed to identify barriers to early HIV diagnosis and to optimize the different steps across the care continuum for transgender women.

Details

Title
Assessing the HIV care continuum among transgender women during 11 years of follow‐up: results from the Netherlands’ ATHENA observational cohort
Author
Jongen, Vita W. 1   VIAFID ORCID Logo  ; Daans, Ceranza 2 ; van Sighem, Ard 3 ; Schim van der Loeff, Maarten 4 ; Hage, Kris 5 ; Welling, Camiel 2 ; von Vaupel‐Klein, Alex 6 ; den Heijer, Martin 7 ; Peters, Edgar J. G. 8 ; van der Valk, Marc 9 ; Reiss, Peter 10 ; Prins, Maria 4 ; Hoornenborg, Elske 4   VIAFID ORCID Logo 

 Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands, Stichting hiv monitoring, Amsterdam, The Netherlands 
 Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands 
 Stichting hiv monitoring, Amsterdam, The Netherlands 
 Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands, Amsterdam UMC, University of Amsterdam, Internal Medicine, Amsterdam, The Netherlands, Amsterdam Institute for Infection and Immunity (AII), Amsterdam, The Netherlands, Amsterdam Public Health Research Institute (APH), Amsterdam, The Netherlands 
 Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands, Amsterdam Institute for Infection and Immunity (AII), Amsterdam, The Netherlands 
 Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands, Trans United Europe, Amsterdam, The Netherlands 
 Amsterdam UMC, Vrije Universiteit Amsterdam, Internal Medicine, Amsterdam, The Netherlands, Center of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands 
 Amsterdam Institute for Infection and Immunity (AII), Amsterdam, The Netherlands, Amsterdam UMC, Vrije Universiteit Amsterdam, Internal Medicine, Amsterdam, The Netherlands 
 Stichting hiv monitoring, Amsterdam, The Netherlands, Amsterdam UMC, University of Amsterdam, Internal Medicine, Amsterdam, The Netherlands, Amsterdam Institute for Infection and Immunity (AII), Amsterdam, The Netherlands 
10  Stichting hiv monitoring, Amsterdam, The Netherlands, Amsterdam UMC, University of Amsterdam, Internal Medicine, Amsterdam, The Netherlands, Amsterdam Public Health Research Institute (APH), Amsterdam, The Netherlands, Amsterdam UMC, University of Amsterdam, Global Health, Amsterdam, The Netherlands, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands 
Section
RESEARCH ARTICLE
Publication year
2024
Publication date
Aug 1, 2024
Publisher
John Wiley & Sons, Inc.
e-ISSN
1758-2652
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3097446427
Copyright
© 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.