Jalil, E.M., Wilson, E.C., Luz, P.M., et al. Journal of the International AIDS Society (September 2017), 20: 21873, doi: 10.7448/IAS.20.1.21873.
This study estimated population-level indicators for the HIV care cascade and elements associated with viral suppression among transwomen in Rio de Janeiro, Brazil. The authors conducted a secondary analysis of a respondent-driven sampling study among 141 self-identified transwomen. Among these women, 89.2 percent had been tested for HIV, 77.5 percent had been diagnosed with HIV, 67.2 percent had been linked to care, 62.2 percent were on antiretroviral treatment (ART), and 35.4 percent had an undetectable viral load. Among the 101 transwomen who knew their HIV status, 80 percent were on ART, and 45 percent had an undetectable viral load. Transwomen who knew their HIV status and were on ART had a higher CD4 count than those who knew their status and were not on ART (695 cells/mm3 versus 398 cells/mm3). Nine transwomen had not been linked to care. Transwomen who were black, earned <US$160/month, or reported unstable housing were less likely to achieve viral suppression. Only around 12 percent of transwomen had access to trans-specific health care services. The authors concluded that transwomen experience significantly lower rates of viral suppression compared to other populations.Focused interventions are required that help them to link to and engage in HIV care and treatment services.