Research Spotlight: Gender-affirming Care Reduces HIV Risk in Trans and Gender-diverse Individuals

A longitudinal study of more than 8,000 transgender and nonbinary people found those receiving gender-affirming hormones were 44% less likely to have transmissible viral loads, if already infected with HIV, and 37% less likely to be infected with HIV compared to those not taking hormones. The study, which was conducted at two Federally Qualified Health Centers (FQHC), Callen-Lorde Community Health Center in New York, NY, and Fenway Health in Boston, MA looked at health data from trans and gender-diverse patients between 2013 and 2019.

Researchers found that being prescribed “[g]ender-affirming hormone therapy …was associated with reduced rates of HIV seropositivity (adjusted risk ratio [RR] 0·63, 95% CI 0·56–0·70) and viral non-suppression (adjusted RR 0·56, 95% CI 0·45–0·69) across follow-up. This despite only 3.1% of the HIV-negative study participants being prescribed PrEP. Of note, Black, Hispanic, and multi-racial patients had higher HIV rates than other study participants.

This longitudinal study of trans participants receiving primary care at federally qualified health centres found that gender-affirming hormone therapy prescribed through informed consent protocols was associated with reduced rates of HIV seropositivity and viral nonsuppression over time. The mechanisms by which gender-affirming hormone therapy affects HIV serostatus and viral suppression outcomes for trans participants in this study remain unclear. Gender-affirming hormone therapy is prospectively associated with reduced mental health distress and improved quality of life; these effects might, in turn, facilitate improved health behaviours, such as condom use or antiretroviral medication adherence. Gender-affirming hormone therapy-related care might also increase trust with providers, thereby reducing barriers to discussing concerns about sexual health or adherence difficulties (p. e289).

My Takeaway

Gender-affirming care is important for reducing HIV risk and should be a part of HIV prevention programs, and incorporated into primary care.

It is important to note that this study was funded in part by a grant from the National Institute of Health (NIH) and is the type of research that is no longer funded under the current administration.

This study also highlights the importance of examining racial and ethnic outcome differences in healthcare research.

Related Content

STAT News has an approachable article summarizing this study and examine the context within which it is published.

The primary author, Dr. Sari Reisner , recently published another article that adds to the mountain of evidence that gender-affirming care reduces depressive symptoms in trans and gender-diverse adults.

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