BACKGROUND: Previous systematic reviews have identified a high prevalence of HIV infection in transgender women in the USA and in those who sell sex (compared with both female and male sex workers). However, little is known about the burden of HIV infection in transgender women worldwide. We aimed to better assess the relative HIV burden in all transgender women worldwide. METHODS: We did a systematic review and meta-analysis of studies that assessed HIV infection burdens in transgender women that were published between Jan 1, 2000, and Nov 30, 2011. Meta-analysis was completed with the Mantel-Haenszel method, and random-effects modelling was used to compare HIV burdens in transgender women with that in adults in the countries for which data were available. FINDINGS: Data were only available for countries with male-predominant HIV epidemics, which included the USA, six Asia-Pacific countries, five in Latin America, and three in Europe. The pooled HIV prevalence was 19·1% (95% CI 17·4-20·7) in 11 066 transgender women worldwide. In 7197 transgender women sampled in ten low-income and middle-income countries, HIV prevalence was 17·7% (95% CI 15·6-19·8). In 3869 transgender women sampled in five high-income countries, HIV prevalence was 21·6% (95% CI 18·8-24·3). The odds ratio for being infected with HIV in transgender women compared with all adults of reproductive age across the 15 countries was 48·8 (95% CI 21·2-76·3) and did not differ for those in low-income and middle-income countries compared with those in high-income countries. INTERPRETATION: Our findings suggest that transgender women are a very high burden population for HIV and are in urgent need of prevention, treatment, and care services. The meta-analysis showed remarkable consistency and severity of the HIV disease burden among transgender women. FUNDING: Center for AIDS Research at Johns Hopkins and the Center for Public Health and Human Rights at the JHU Bloomberg School of Public Health.
BACKGROUND: Previous systematic reviews have identified a high prevalence of HIV infection in transgender women in the USA and in those who sell sex (compared with both female and male sex workers). However, little is known about the burden of HIV infection in transgender women worldwide. We aimed to better assess the relative HIV burden in all transgender women worldwide. METHODS: We did a systematic review and meta-analysis of studies that assessed HIV infection burdens in transgender women that were published between Jan 1, 2000, and Nov 30, 2011. Meta-analysis was completed with the Mantel-Haenszel method, and random-effects modelling was used to compare HIV burdens in transgender women with that in adults in the countries for which data were available. FINDINGS: Data were only available for countries with male-predominant HIV epidemics, which included the USA, six Asia-Pacific countries, five in Latin America, and three in Europe. The pooled HIV prevalence was 19·1% (95% CI 17·4-20·7) in 11 066 transgender women worldwide. In 7197 transgender women sampled in ten low-income and middle-income countries, HIV prevalence was 17·7% (95% CI 15·6-19·8). In 3869 transgender women sampled in five high-income countries, HIV prevalence was 21·6% (95% CI 18·8-24·3). The odds ratio for being infected with HIV in transgender women compared with all adults of reproductive age across the 15 countries was 48·8 (95% CI 21·2-76·3) and did not differ for those in low-income and middle-income countries compared with those in high-income countries. INTERPRETATION: Our findings suggest that transgender women are a very high burden population for HIV and are in urgent need of prevention, treatment, and care services. The meta-analysis showed remarkable consistency and severity of the HIV disease burden among transgender women. FUNDING: Center for AIDS Research at Johns Hopkins and the Center for Public Health and Human Rights at the JHU Bloomberg School of Public Health.
Authors: Kristi E Gamarel; Kimberly M Nelson; Rob Stephenson; Olga J Santiago Rivera; Danielle Chiaramonte; Robin Lin Miller Journal: AIDS Behav Date: 2018-02
Authors: Sarah MacCarthy; Tonia Poteat; Zhiyu Xia; Nicolette L Roque; Ashley Hyun Jin Kim; Stefan Baral; Sari L Reisner Journal: Sex Health Date: 2017-10 Impact factor: 2.706
Authors: Linda-Gail Bekker; George Alleyne; Stefan Baral; Javier Cepeda; Demetre Daskalakis; David Dowdy; Mark Dybul; Serge Eholie; Kene Esom; Geoff Garnett; Anna Grimsrud; James Hakim; Diane Havlir; Michael T Isbell; Leigh Johnson; Adeeba Kamarulzaman; Parastu Kasaie; Michel Kazatchkine; Nduku Kilonzo; Michael Klag; Marina Klein; Sharon R Lewin; Chewe Luo; Keletso Makofane; Natasha K Martin; Kenneth Mayer; Gregorio Millett; Ntobeko Ntusi; Loyce Pace; Carey Pike; Peter Piot; Anton Pozniak; Thomas C Quinn; Jurgen Rockstroh; Jirair Ratevosian; Owen Ryan; Serra Sippel; Bruno Spire; Agnes Soucat; Ann Starrs; Steffanie A Strathdee; Nicholas Thomson; Stefano Vella; Mauro Schechter; Peter Vickerman; Brian Weir; Chris Beyrer Journal: Lancet Date: 2018-07-20 Impact factor: 79.321
Authors: N Harawa; L Wilton; L Wang; C Mao; I Kuo; T Penniman; S Shoptaw; S Griffith; J K Williams; V Cummings; K Mayer; B Koblin Journal: AIDS Behav Date: 2014-08