Table 2.
Comparison of Substance Use and Clinical Outcomes Among Adults with Diagnosed HIV Between Those Who Identified as Transgender Women Versus Cisgender Men or Cisgender Women—Medical Monitoring Project, United States, 2015–2020 (N= 23,697)
|
Transgender women
|
Cisgender men
|
Cisgender women
|
Comparison of transgender women with cisgender men
|
Comparison of transgender women with cisgender women
|
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|---|---|---|---|---|---|---|---|---|---|---|
|
(n = 362) |
(n = 17,319) |
(n = 6016) |
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| n | col % (95% CI) | n | col % (95% CI) | n | col % (95% CI) | Prevalence ratio (95% CI) | p | Prevalence ratio (95% CI) | p | |
| Substance use | ||||||||||
| Binge drinking | ||||||||||
| Yes | 52 | 15.3 (10.8–19.8) | 2991 | 17.4 (16.5–18.3) | 604 | 10.1 (9.2–11.1) | 0.88 (0.65–1.19) | 0.374 | 1.51 (1.11–2.06) | 0.028 |
| No | 298 | 84.7 (80.2–89.2) | 14,108 | 82.6 (81.7–83.5) | 5326 | 89.9 (88.9–90.8) | 1.03 (0.97–1.08) | — | — | — |
| Noninjection drug use | ||||||||||
| Yes | 135 | 35.6 (30.0–41.3) | 6115 | 35.0 (33.7–36.2) | 1111 | 19.0 (17.6–20.5) | 1.02 (0.87–1.20) | 0.821 | 1.87 (1.57–2.23) | <0.001 |
| No | 222 | 64.4 (58.7–70.0) | 11,030 | 65.0 (63.8–66.3) | 4839 | 81.0 (79.5–82.4) | 0.99 (0.90–1.08) | — | — | — |
| Clinical outcomes | ||||||||||
| Retention in care | ||||||||||
| Yes | 292 | 79.3 (73.6–85.0) | 13,875 | 77.8 (76.6–78.9) | 4882 | 78.1 (76.5–79.8) | 1.02 (0.95–1.10) | — | — | — |
| No | 53 | 20.7 (15.0–26.4) | 2695 | 22.2 (21.1–23.4) | 930 | 21.9 (20.2–23.5) | 0.93 (0.71–1.23) | 0.608 | 0.95 (0.72–1.25) | 0.697 |
| ART use and adherence | ||||||||||
| Not currently taking ART or not 100% adherent | 203 | 57.2 (51.5–63.0) | 7192 | 43.3 (42.3–44.3) | 2555 | 45.1 (43.5–46.7) | 1.32 (1.19–1.46) | <0.001 | 1.27 (1.14–1.41) | <0.001 |
| 100% adherent to ART | 154 | 42.8 (37.0–48.5) | 9977 | 56.7 (55.7–57.7) | 3397 | 54.9 (53.3–56.5) | 0.75 (0.66–0.86) | — | — | — |
| Viral suppression at last test, past 12 monthsa | ||||||||||
| Yes | 259 | 66.8 (60.8–72.8) | 12,974 | 69.0 (67.4–70.7) | 4319 | 66.6 (64.7–68.6) | 0.97 (0.89–1.06) | — | — | — |
| No | 103 | 33.2 (27.2–39.2) | 4345 | 31.0 (29.3–32.6) | 1697 | 33.4 (31.4–35.3) | 1.07 (0.90–1.28) | 0.455 | 1.00 (0.83–1.20) | 0.966 |
| Sustained viral suppression, past 12 monthsb | ||||||||||
| Yes | 233 | 61.0 (55.0–67.1) | 11,768 | 62.8 (61.3–64.4) | 3854 | 60.0 (58.1–61.9) | 0.97 (0.88–1.07) | — | — | — |
| No | 129 | 39.0 (32.9–45.0) | 5551 | 37.2 (35.6–38.7) | 2162 | 40.0 (38.1–41.9) | 1.05 (0.90–1.23) | 0.565 | 0.97 (0.83–1.14) | 0.738 |
| ≥1 Emergency room visit, past 12 months | ||||||||||
| Yes | 158 | 40.7 (34.7–46.6) | 6475 | 37.6 (36.5–38.6) | 2636 | 43.7 (41.8–45.6) | 1.08 (0.93–1.26) | 0.318 | 0.93 (0.80–1.08) | 0.339 |
| No | 200 | 59.3 (53.4–65.3) | 10,746 | 62.4 (61.4–63.5) | 3327 | 56.3 (54.4–58.2) | 0.95 (0.86–1.05) | — | — | — |
| ≥1 Hospitalization, past 12 months | ||||||||||
| Yes | 68 | 17.5 (12.8–22.2) | 2942 | 16.4 (15.7–17.1) | 1345 | 21.6 (20.3–22.9) | 1.07 (0.81–1.40) | 0.658 | 0.81 (0.62–1.07) | 0.101 |
| No | 289 | 82.5 (77.8–87.2) | 14,278 | 83.6 (82.9–84.3) | 4617 | 78.4 (77.1–79.7) | 0.99 (0.93–1.05) | — | — | — |
| Symptoms of moderate or severe GAD, past 2 weeksc | ||||||||||
| Yes | 86 | 22.4 (17.4–27.4) | 2533 | 15.3 (14.4–16.1) | 1139 | 19.2 (17.7–20.7) | 1.47 (1.18–1.83) | 0.004 | 1.17 (0.94–1.46) | 0.202 |
| No | 268 | 77.6 (72.6–82.6) | 14,603 | 84.7 (83.9–85.6) | 4792 | 80.8 (79.3–82.3) | 0.92 (0.86–0.98) | — | — | — |
| Symptoms of major/other depression, past 2 weeksd | ||||||||||
| Yes | 89 | 23.9 (18.8–29.1) | 2913 | 17.3 (16.5–18.1) | 1335 | 22.6 (21.1–24.0) | 1.38 (1.12–1.71) | 0.010 | 1.06 (0.87–1.30) | 0.580 |
| No | 264 | 76.1 (70.9–81.2) | 14,173 | 82.7 (81.9–83.5) | 4577 | 77.4 (76.0–78.9) | 0.92 (0.86–0.98) | — | — | — |
Frequencies are unweighted. Percentages are weighted. Confidence intervals incorporate weighted percentages.
Defined as the most recent viral load documented as undetectable or <200 copies/mL.
Defined as all viral loads in the past 12 months documented as undetectable or <200 copies/mL.
Responses to the GAD-7 were used to define “mild anxiety,” “moderate anxiety,” and “severe anxiety” according to the criteria from the DSM-IV. “Severe anxiety” was defined as having a score of ≥15; “moderate anxiety” was defined as having a score of 10–14; and “mild anxiety” was defined as having a score of 5–9.
Responses to the items on PHQ-8 were used to define “major depression” and “other depression” according to the criteria from the DSM-IV. “Major depression” was defined as having at least five symptoms of depression; “other depression” was defined as having two to four symptoms of depression. The PHQ-8 classification of “other depression” comprises the DSM-IV categories of dysthymia and depressive disorder, not otherwise specified, which include minor or subthreshold depression.
ART, antiretroviral therapy; GAD, generalized anxiety disorder; PHQ, Patient Health Questionnaire.