Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus.

Sevelius, Jae M.; Patouhas, Enzo; Keatley, JoAnne G.; Johnson, Mallory O.

doi:10.1007/s12160-013-9565-8

Cited by 345HIV/AIDS Research and InterventionsLGBTQ Health, Identity, and PolicyHIV, Drug Use, Sexual Risk

Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus.

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Sevelius, Jae M., Patouhas, Enzo, Keatley, JoAnne G., Johnson, Mallory O.·2014·Annals of Behavioral Medicine

DOI 10.1007/s12160-013-9565-8PMC PMC3925767

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Abstract

BACKGROUND: Transgender women have 49 times the odds of human immunodeficiency virus (HIV) infection compared to other groups, yet they are disproportionately underserved by current treatment efforts. PURPOSE: This study aimed to examine culturally unique barriers and facilitators to engagement and retention in HIV care and strengthen efforts to mitigate health disparities, guided by the Models of Gender Affirmation and Health Care Empowerment. METHODS: Through 20 interviews and five focus groups (n = 38), transgender women living with HIV discussed their experiences and life contexts of engagement in and adherence to HIV care and treatment. RESULTS: Our participants faced substantial challenges to adhering to HIV care and treatment, including avoidance of healthcare due to stigma and past negative experiences, prioritization of hormone therapy, and concerns about adverse interactions between antiretroviral treatment for HIV and hormone therapy. Receiving culturally competent, transgender-sensitive healthcare was a powerful facilitator of healthcare empowerment. CONCLUSIONS: Recommendations are offered to inform intervention research and guide providers, emphasizing gender affirming HIV care that integrates transition-related healthcare needs.

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Transgender persons often experience high rates of stigma and socioeconomic and structural barriers to care that negatively affect health care usage and increase susceptibility to HIV and STIs.
“Transgender persons often experience high rates of stigma and socioeconomic and structural barriers to care that negatively affect health care usage and increase susceptibility to HIV and STIs (326–332).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [330]
The Discussion reports that stigma, transphobia, poverty, and other barriers limited healthcare access and HIV-care engagement among transgender women living with HIV. The Results also describe avoidance of HIV testing before diagnosis. The paper does not establish that these barriers increase susceptibility to HIV or STIs across transgender persons generally; its discussion of HIV transmission concerns people already living with HIV. (LLM, conf=0.87)
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[50]Sevelius J Carrico A Johnson M Antiretroviral therapy adherence among transgender women living with HIV Journal of the Association of Nurses in AIDS Care 21 3 256 264 20347342 PMC2859994
[56]Johnson MO The Shifting Landscape of Health Care: Toward a Model of Health Care Empowerment American Journal of Public Health 2011 101 2 265 270 21164096 PMC3020216

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Correlates of Engagement in HIV Care Among Transgender Women of Color in the United States of America
Sevelius, J. M., Xavier, J. M., Chakravarty, D., Keatley, J. G., Shade, S. B., Rebchook, G., & The SPNS Transgender Women of Color Study Group (2021) · AIDS and Behavior · doi:10.1007/s10461-021-03306-9 · Cited by 24 · see citing works
1848. Barriers and Facilitators to HIV Care in the Transgender Population
Martinez, D. A., Hines, D., Inurritegui-Lint, A., Pillinger, K. E., Simone, L., & Molloy, L. M. (2023) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofad500.1676

Authors: Sevelius, J. M., Patouhas, E., Keatley, J. G., & Johnson, M. O.
Affiliations: University of California, San Francisco (US)
Corresponding author: Sevelius, Jae M.
ORCID: Sevelius, Jae M.
Johnson, Mallory O.
Venue: Annals of Behavioral Medicine
Publisher: Oxford University Press (OUP)
Published: 2013-12-07
Volume: 47
Issue: 1
Pages: 5-16
ISSN: 0742-5554 (ISSN-L)
0883-6612
1532-4796
DOI: 10.1007/s12160-013-9565-8
PMC: PMC3925767
OpenAlex: W2009747821
Cited by: 345
References: 51
Citations by year: 2026: 10 · 2025: 21 · 2024: 25 · 2023: 33 · 2022: 31 · 2021: 44 · 2020: 31 · 2019: 50 · 2018: 26 · 2017: 23 · 2016: 24 · 2015: 14 · 2014: 6 · 2013: 1
FWCI: 10.90
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Annals of Behavioral Medicine (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: California HIV/AIDS Research Program
National Institute of Mental Health (K24MH087220, K08MH085566)
National Institute of Allergy and Infectious Diseases (P30AI027763)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords: transgender women, HIV, HIV care engagement, retention in care, barriers and facilitators, gender-affirming care, health disparities, HIV stigma, hormone therapy, antiretroviral therapy adherence
MeSH terms: Adult, Aged, Female, Health Services Accessibility, Humans, Male, Middle Aged, Patient Compliance, Women, HIV Infections, Focus Groups, Healthcare Disparities, Social Stigma, Transgender Persons

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Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus.

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