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

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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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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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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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