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Identifying and Characterizing Trans women in the Swiss HIV Cohort Study as an Epidemiologically Distinct Risk Group

Huyen Nguyen, Benjamin Hampel, David Garcia Nuñez, Manuel Battegay, Anna Hachfeld, Enos Bernasconi, Alexandra Calmy, Matthias Cavassini, Pietro Vernazza, Jacques Fellay, Hannes Rudolph, Michael Huber, Karoline Leuzinger, Matthieu Perreau, Alexandra Scherrer, Alban Nicolas Ramette, Sabine Yerly, Huldrych F Günthard, Roger D Kouyos, Katharina Kusejko & Swiss HIV Cohort Study

abstract

BACKGROUND
As trans women are disproportionately affected by the HIV epidemic, and are still understudied, we aimed to identify and characterize the trans women in the Swiss HIV Cohort Study (SHCS).

METHODS
A combination of criteria from pre-existing cohort data was used to identify trans women. Information on socioeconomic factors, clinical data, risk behaviors, and mental health was collected. We also described their phylogenetic patterns within HIV transmission networks in relation to other risk groups.

RESULTS
We identified 89 trans women out of a total 20925 cohort participants. Trans women were much more likely to be Asian (30.3%) and Hispanic (15.7%) compared to men-who-have-sex with-men/MSM (2.5% and 4.1%, P value<0.001) and cis heterosexual (HET) women (7.0% and 3.3%, P value<0.001). Trans women were more similar to cis HET women in some measures like education level (post-secondary education attainment: 22.6% and 20.7% [P value =0.574], vs. 46.5% for MSM [P value<0.001]), while being more similar to MSM for measures like prior syphilis diagnosis (36.0% and 44.0% [P value=0.170], vs. 6.7% for cis HET women [P value <0.001]). 11.2% of trans women have been priorly hospitalized for psychological reasons, compared to 4.2% of MSM (P value=0.004) and 5.1% of cis HET women (P value=0.025). An analysis of transmission clusters containing trans women suggested greater affinity within the transmission networks to MSM compared to cis HET women.

CONCLUSIONS
Trans women are epidemiologically distinct in the setting of the Swiss HIV epidemic, warranting better identification and study to better serve this underserved risk group.
   
citation Nguyen H, Hampel B, Nuñez D G, Battegay M, Hachfeld A, Bernasconi E, Calmy A, Cavassini M, vernazza p, Fellay J, Rudolph H, Huber M, Leuzinger K, Perreau M, Scherrer A, Ramette A N, Yerly S, Günthard H F, Kouyos R D, Kusejko K, Swiss HIV Cohort Study . Identifying and Characterizing Trans women in the Swiss HIV Cohort Study as an Epidemiologically Distinct Risk Group. Clin Infect Dis 2021;.
   
type journal paper/review (English)
date of publishing 20-07-2021
journal title Clin Infect Dis
ISSN electronic 1537-6591
PubMed 34282827
DOI 10.1093/cid/ciab628