Transgender Women Diagnosed With HIV Less Likely to Receive Partner Services

For people newly diagnosed with HIV, it can be daunting to inform partners of the potential for virus transmission. Partner services are an important strategy for health workers to inform those at risk as promptly as possible.

The authors of a new US Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report have found that transgender women diagnosed with HIV are less likely to receive partner services, compared to other people receiving the same diagnosis.

In explaining the need for analyzing partner services among transgender women, CDC authors pointed to a recent meta-analysis of US studies conducted between 2006-17 which identified a 14.2% mean estimated laboratory-confirmed prevalence of HIV infection among transgender women.

Investigators from the CDC Division of HIV/AIDS Prevention used data submitted by 61 different health departments from 2013-17 to assess the current state of partner services among transgender women.

Partners were defined as both sexual partners and needle-sharing partners among those who use injection drugs. Transgender women were identified by self-reported sex at birth and current gender identity.

Among 208,304 people in the data set who were diagnosed with HIV, 1727 (.8%) were transgender women. Of these women, 71.5% were interviewed for partner services.

Comparatively, all other groups combined were interviewed 81.1% of the time.

There were 1089 transgender women who were named as partners by people diagnosed with HIV, 775 (71.2%) were notified of potential HIV exposure. Among all partners in the data set combined, 77.1% were notified of potential HIV exposure.

Of all 102,500 notified partners total, 52,071 (50.8%) were tested for HIV. Of transgender women who were notified of potential exposure, only 46.5% were tested for HIV. Approximately 1 in 5 of the transgender women tested received a new HIV diagnosis.

Compared with transgender women partners who were white, transgender women partners who were black were less likely to be tested for HIV.

The authors identified several reasons transgender women in the United States are less likely to receive adequate treatment and prevention services, including unstable housing, limits on employment options, greater participation in sex work, and stigma related to gender identity.

“Efforts to address social and structural barriers to effective implementation of partner services among transgender women, including client concerns about compromised confidentiality and fear of negative impacts (eg, abuse, stigmatization, medical mistrust, and abandonment), would improve partner services delivery in this disproportionately affected population,” the authors wrote.

Combatting these barriers would likely improve partner service provision and lower the underlying rate of HIV incidence. As it stands, transgender women are not receiving partner services on par with other populations.