Table 4.

Associations Between Unmet Needs for Ancillary Services and Clinical Outcomes Among Transgender Women with Diagnosed HIV—Medical Monitoring Project, United States, 2015–2020 (N= 362)

	≥1 Unmet HIV support service						≥1 Unmet non-HIV clinical service						≥1 Unmet subsistence services
	Yes		No				Yes		No				Yes		No
	n	col % (95% CI)	n	col % (95% CI)	Adjusted prevalence ratio (95% CI)	p	n	col % (95% CI)	n	col % (95% CI)	Adjusted prevalence ratio (95% CI)	p	n	col % (95% CI)	n	col % (95% CI)	Adjusted prevalence ratio (95% CI)	p
Retention in carea
Yes	44	71.5 (56.7–86.3)	246	80.8 (74.5–87.1)	—	—	104	80.7 (70.0–91.3)	185	78.6 (71.6–85.6)	—	—	105	74.4 (64.2–84.5)	184	82.0 (75.2–88.8)	—	—
No	12	28.5 (13.7–43.3)	40	19.2 (12.9–25.5)	1.34 (0.67–2.68)	0.451	14	19.3 (8.7–30.0)	37	21.4 (14.4–28.4)	0.81 (0.43–1.52)	0.499	20	25.6 (15.5–35.8)	31	18.0 (11.2–24.8)	1.36 (0.76–2.43)	0.316
ART use and adherence
Not currently taking ART or not 100% adherent	40	72.1 (59.6–84.6)	163	54.5 (48.2–60.9)	1.28 (1.04–1.58)	0.026	77	66.9 (56.9–77.0)	126	52.8 (45.9–59.7)	1.23 (1.00–1.50)	0.057	90	71.9 (63.1–80.6)	113	49.7 (42.1–57.3)	1.39 (1.13–1.70)	0.002
100% adherent to ART	18	27.9 (15.4–40.4)	136	45.5 (39.1–51.8)	—	—	45	33.1 (23.0–43.1)	108	47.2 (40.3–54.1)	—	—	38	28.1 (19.4–36.9)	115	50.3 (42.7–57.9)	—	—
Viral suppression at last test, past 12 monthsb
Yes	34	55.0 (39.4–70.7)*	224	69.2 (62.4–76.1)	—	—	84	63.1 (52.5–73.7)	174	70.0 (62.8–77.2)	—	—	83	57.9 (48.1–67.7)	175	73.0 (65.7–80.2)	—	—
No	24	45.0 (29.3–60.6)*	77	30.8 (23.9–37.6)	1.34 (0.87–2.08)	0.223	39	36.9 (26.3–47.5)	60	30.0 (22.8–37.2)	1.11 (0.78–1.58)	0.583	45	42.1 (32.3–51.9)	54	27.0 (19.8–34.3)	1.50 (1.05–2.12)	0.028
Sustained viral suppression, past 12 monthsc
Yes	29	47.5 (32.6–62.4)	203	63.7 (56.8–70.6)	—	—	73	55.8 (45.4–66.2)	159	64.9 (57.5–72.2)	—	—	70	50.6 (41.2–60.0)	162	67.9 (60.4–75.3)	—	—
No	29	52.5 (37.6–67.4)	98	36.3 (29.4–43.2)	1.33 (0.93–1.90)	0.145	50	44.2 (33.8–54.6)	75	35.1 (27.8–42.5)	1.13 (0.83–1.53)	0.450	58	49.4 (40.0–58.8)	67	32.1 (24.7–39.6)	1.47 (1.09–1.98)	0.011
≥1 Emergency room visit, past 12 months
Yes	32	54.5 (40.7–68.4)	126	38.2 (31.4–44.9)	1.40 (1.01–1.93)	0.059	63	47.9 (37.4–58.4)	95	37.9 (30.9–44.9)	1.26 (0.95–1.66)	0.115	65	50.9 (40.1–61.6)	93	36.0 (29.0–43.0)	1.42 (1.06–1.90)	0.024
No	26	45.5 (31.6–59.3)	174	61.8 (55.1–68.6)	—	—	60	52.1 (41.6–62.6)	138	62.1 (55.1–69.1)	—	—	63	49.1 (38.4–59.9)	135	64.0 (57.0–71.0)	—	—
Hospitalized overnight ≥1 time, past 12 months
Yes	16	26.7 (14.7–38.7)	52	15.9 (11.1–20.7)	1.72 (1.03–2.88)	0.078	24	19.2 (11.5–26.9)	44	17.0 (11.1–22.9)	1.15 (0.69–1.93)	0.598	28	22.0 (12.9–31.2)	40	15.4 (10.3–20.6)	1.46 (0.88–2.42)	0.174
No	41	73.3 (61.3–85.3)	248	84.1 (79.3–88.9)	—	—	97	80.8 (73.1–88.5)	190	83.0 (77.1–88.9)	—	—	99	78.0 (68.8–87.1)	188	84.6 (79.4–89.7)	—	—
Symptoms of moderate or severe GAD, past 2 weeksd
Yes	31	53.2 (37.9–68.5)*	55	16.8 (12.1–21.6)	3.16 (2.11–4.74)	<0.001	46	36.7 (25.6–47.8)	40	15.7 (10.8–20.7)	2.35 (1.52–3.63)	<0.001	53	40.7 (30.7–50.8)	33	12.9 (8.2–17.7)	3.20 (2.05–5.00)	<0.001
No	26	46.8 (31.5–62.1)*	242	83.2 (78.4–87.9)	—	—	75	63.3 (52.2–74.4)	193	84.3 (79.3–89.2)	—	—	73	59.3 (49.2–69.3)	195	87.1 (82.3–91.8)	—	—
Symptoms of major/other depression, past 2 weekse
Yes	31	55.5 (40.8–70.3)	58	18.1 (13.6–22.6)	3.10 (2.21–4.36)	<0.001	38	31.2 (20.8–41.6)	51	20.5 (14.9–26.1)	1.53 (1.01–2.33)	0.063	47	40.2 (30.0–50.3)	42	15.5 (10.5–20.5)	2.74 (1.83–4.10)	<0.001
No	27	44.5 (29.7–59.2)	237	81.9 (77.4–86.4)	—	—	83	68.8 (58.4–79.2)	181	79.5 (73.9–85.1)	—	—	79	59.8 (49.7–70.0)	185	84.5 (79.5–89.5)	—	—

Frequencies are unweighted. Percentages are weighted. Confidence intervals incorporate weighted percentages. Estimates with an absolute CI width ≥30, estimates with an absolute CI width between 5 and 30 and a relative CI width >130%, and estimates of 0% or 100% are marked with an asterisk (*) and should be interpreted with caution. Prevalence ratios are adjusted for age and race/ethnicity.

^aRetention in care: Two elements of outpatient HIV care (encounter with an HIV care provider, viral load test result, CD4 test result, HIV resistance test or tropism assay, ART prescription, pneumocystis pneumonia prophylaxis, or mycobacterium avium complex prophylaxis) at least 90 days apart in each 12-month period.

^bMost recent viral suppression at last test was an undetectable viral load or <200 copies/mL. Viral load measurements are from medical record abstraction.

^cSustained viral suppression: All viral load measurements documented undetectable or <200 copies/mL. Viral load measurements are from medical record abstraction.

^dModerate or severe GAD: 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.

^eMajor or other depression: Responses to the items on PHQ-8 were used to define “major depression” and “other depression” according to the criteria from 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.