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Intersecting Structural and Psychosocial Conditions: Investigating Injection Drug Use and HIV Among Transgender

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Transgender women who inject drugs face higher HIV prevalence and are less likely to receive HIV treatment. Increased access to nonjudgmental harm reduction services is crucial for this vulnerable population.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Substance Use Research

Background:

  • Transgender women experience significant health disparities, with HIV infection being a major concern.
  • Substance use is more prevalent in transgender women compared to cisgender women.
  • Limited data exists on HIV risk and injection behaviors among transgender women who inject drugs in the U.S.

Purpose of the Study:

  • To investigate HIV prevalence among transgender women who inject drugs.
  • To examine injection-related behaviors and HIV prevention/care outcomes in this population.
  • To compare transgender women who inject drugs with a general sample of people who inject drugs.

Main Methods:

  • Utilized data from the National HIV Behavioral Surveillance (2019-2020).
  • Recruited participants using respondent-driven sampling.
  • Conducted interviews and HIV testing; employed log-linked Poisson regression for analysis.

Main Results:

  • 7% of 1561 transgender women reported injecting drugs in the past 12 months.
  • HIV prevalence was 1.5 times higher in transgender women who inject drugs.
  • Transgender women who inject drugs were less likely to be on antiretroviral therapy (ART).
  • Methamphetamine was the most commonly injected drug; most used syringe services programs.

Conclusions:

  • Transgender women who inject drugs face significant health challenges, including high HIV prevalence and associated psychosocial conditions.
  • Conditions like homelessness, incarceration, and exchange sex exacerbate risks for this group.
  • Culturally competent, nonjudgmental harm reduction services are recommended to improve health outcomes.