Patterns of Exposure to Socio-structural Stressors and HIV Care Engagement Among Transgender Women of Color

Transgender women are disproportionately affected by HIV and experiences of social adversity that may interfere with engagement in care and viral suppression. We used latent class analysis to examine patterns of social adversity and their impact on HIV care continuum outcomes in an urban sample of t...

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Bibliographic Details
Published in:AIDS and behavior 2020-11, Vol.24 (11), p.3155-3163
Main Authors: Hotton, Anna L., Perloff, Judy, Paul, Josie, Parker, Channyn, Ducheny, Kelly, Holloway, Trisha, Johnson, Amy K., Garofalo, Robert, Swartz, James, Kuhns, Lisa M.
Format: Article
Language:English
Subjects:
Adult
African Americans - psychology
Aged
Aged, 80 and over
Anti-Retroviral Agents - therapeutic use
Continuity of Patient Care - statistics & numerical data
Female
Health Psychology
HIV Infections - drug therapy
HIV Infections - ethnology
HIV Infections - psychology
HIV Infections - virology
Humans
Infectious Diseases
Latent Class Analysis
Male
Medicine
Medicine & Public Health
Middle Aged
Original Paper
Public Health
Quality of Life
Social Stigma
Transgender Persons - psychology
Transgender Persons - statistics & numerical data
Viral Load
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Summary:Transgender women are disproportionately affected by HIV and experiences of social adversity that may interfere with engagement in care and viral suppression. We used latent class analysis to examine patterns of social adversity and their impact on HIV care continuum outcomes in an urban sample of transgender women of color. Participants (n = 224) were median age 29 and 86% non-Hispanic Black. Lack of resources, unemployment, and housing instability were reported by over 50%, and 41% reported history of incarceration. Latent class analysis identified 2 distinct classes representing higher and lower levels of social adversity. In latent class regression, membership in the higher social adversity class was associated with statistically significantly lower odds of viral suppression and HIV care engagement in univariate analysis; when adjusted for age, race, and recruitment site the association remained statistically significant for viral suppression (aOR 0.38, 95% CI 0.18–0.79; chi-square = 6.681, d.f. = 1, p = 0.010), though not for HIV care engagement. Our findings highlight the impact of socio-structural barriers on engagement in the HIV care continuum among transgender women.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-020-02874-6