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Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus.
Open accessAbstract
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 (326–332).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [330]
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Metadata
- Authors
- Sevelius, J. M., Patouhas, E., Keatley, J. G., & Johnson, M. O.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Sevelius, Jae M.
- 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
- 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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