Cited by 1,461HIV/AIDS Research and InterventionsHIV, Drug Use, Sexual RiskLGBTQ Health, Identity, and Policy

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Worldwide burden of HIV in transgender women: a systematic review and meta-analysis.

Baral, Stefan D, Poteat, Tonia, Strömdahl, Susanne, Wirtz, Andrea L, Guadamuz, Thomas E, Beyrer, Chris·2013·The Lancet Infectious Diseases

DOI 10.1016/s1473-3099(12)70315-8

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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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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
ORCID: Baral, Stefan D
Poteat, Tonia
Strömdahl, Susanne
Wirtz, Andrea L
Guadamuz, Thomas E
Beyrer, Chris
Venue: The Lancet Infectious Diseases
Publisher: Elsevier BV
Published: 2013-03
Volume: 13
Issue: 3
Pages: 214-222
ISSN: 1473-3099 (ISSN-L)
DOI: 10.1016/s1473-3099(12)70315-8
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
FWCI: 5.79
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
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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Worldwide burden of HIV in transgender women: a systematic review and meta-analysis.

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