Worldwide burden of HIV in transgender women: a systematic review and meta-analysis.
Abstract
Background Previous systematic reviews have identified a high prevalence of HIV infection in transgender women in the USA and in those who sell sex (compared with both female and male sex workers). However, little is known about the burden of HIV infection in transgender women worldwide. We aimed to better assess the relative HIV burden in all transgender women worldwide.Methods We did a systematic review and meta-analysis of studies that assessed HIV infection burdens in transgender women that were published between Jan 1, 2000, and Nov 30, 2011. Meta-analysis was completed with the Mantel-Haenszel method, and random-effects modelling was used to compare HIV burdens in transgender women with that in adults in the countries for which data were available.Findings Data were only available for countries with male-predominant HIV epidemics, which included the USA, six Asia-Pacific countries, five in Latin America, and three in Europe. The pooled HIV prevalence was 19·1% (95% CI 17·4-20·7) in 11 066 transgender women worldwide. In 7197 transgender women sampled in ten low-income and middle-income countries, HIV prevalence was 17·7% (95% CI 15·6-19·8). In 3869 transgender women sampled in five high-income countries, HIV prevalence was 21·6% (95% CI 18·8-24·3). The odds ratio for being infected with HIV in transgender women compared with all adults of reproductive age across the 15 countries was 48·8 (95% CI 21·2-76·3) and did not differ for those in low-income and middle-income countries compared with those in high-income countries.Interpretation Our findings suggest that transgender women are a very high burden population for HIV and are in urgent need of prevention, treatment, and care services. The meta-analysis showed remarkable consistency and severity of the HIV disease burden among transgender women.Funding Center for AIDS Research at Johns Hopkins and the Center for Public Health and Human Rights at the JHU Bloomberg School of Public Health.
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High rates of HIV infection occur among transgender women worldwide.
“Data also demonstrate high rates of HIV infection among transgender women worldwide (345).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [345]
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- Authors
- Baral, S. D., Poteat, T., Strömdahl, S., Wirtz, A. L., Guadamuz, T. E., & Beyrer, C.
- Affiliations
- Johns Hopkins University (US)
- University of Pittsburgh (US)
- Corresponding author
- Baral, Stefan D
- Venue
- The Lancet Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 13
- Issue
- 3
- Pages
- 214-222
- ISSN
- 1473-3099 (ISSN-L)
- OpenAlex
- W2115046127
- Cited by
- 1,461
- References
- 73
- Citations by year
- 2026: 60 · 2025: 68 · 2024: 85 · 2023: 107 · 2022: 135 · 2021: 148 · 2020: 181 · 2019: 176 · 2018: 130 · 2017: 102 · 2016: 111 · 2015: 74 · 2014: 49 · 2013: 22 · 2012: 1
- FWCI
- 5.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (K01MH085567)
- National Institute of Allergy and Infectious Diseases (P30AI094189)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Keywords
- HIV infection, transgender women, HIV prevalence, HIV burden, sex workers, low- and middle-income countries, high-income countries, HIV prevention, HIV care and treatment
- MeSH terms
- Asia, Developing Countries, El Salvador, Female, Humans, Italy, Male, Netherlands, South America, Spain, United States, Global Health, HIV Infections, Prevalence, Developed Countries, Transgender Persons
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