title: Medication adherence among transgender women living with HIV.
abstract: Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the US report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore the factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transgender women. This secondary analysis is based on data collected from the Symptom and Genetic Study that included a convenience sample of 22 self-identified transgender women, 201 non-transgender men, and 72 non-transgender women recruited in northern California. Self-reported medication adherence was assessed using the AIDS Clinical Trials Group Adherence Questionnaire. Gender differences in demographic and clinical variables were assessed, as were differences between transgender women reporting high and low adherence. Transgender women had lower adherence to medications compared to non-transgender males and non-transgender females (p = .028) and were less likely to achieve viral suppression (p = .039). Within the transgender group, Black/African-Americans reported better adherence than participants who were Whites/Caucasian or other races (p = .009). Adherence among transgender women was unrelated to medication count and estrogen therapy, but consistent with other reports on the HIV population as a whole; transgender women with high adherence were more likely to achieve viral suppression compared to the transgender women with low adherence. Despite the high incidence of HIV infection in the transgender population, few studies focus on TWLWH, either in regard to their adherence to antiretroviral therapies or to their healthcare in general. To address ongoing health disparities, more studies are needed focusing on the transgender population's continuum of care in HIV therapies.
authors.affiliation: a Department of Community Health Systems , University of California , San Francisco , CA , USA.
authors.forename: Glenda N
authors.initials: GN
authors.lastname: Baguso
authors.affiliation: b Department of Family Health Care Nursing , University of California , San Francisco , CA , USA.
authors.forename: Caryl L
authors.initials: CL
authors.lastname: Gay
authors.affiliation: b Department of Family Health Care Nursing , University of California , San Francisco , CA , USA.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Lee
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002140:California / Q000208:ethnology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D012725:Sexual Behavior; D063106:Transgender Persons / Q000523:psychology*; D014189:Transsexualism; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; gender identity; health disparities; medication adherence; transgender