Factors Associated with HIV Testing History and HIV Seropositivity in a Large National Sample of Transgender Adults - Abstract
Purpose: This paper looks at rates of HIV testing and HIV seropositivity among transgender adults. It also explores the factors associated with greater odds of having been tested for HIV and greater odds of testing positive for HIV, and investigates the presence of syndemic effects.
Methods: Data from the 2015 U.S. National Transgender Survey were used to examine the “triple whammy” relationship in a sample of 27,715 transgender Americans aged 18 or older. Odds ratios and multivariate logistic regression were used to examine the data.
Results: 51.5% of the respondents had ever been tested for HIV, and only 24% of those individuals (12.4% of the sample) had been tested during the previous year. The HIV seropositivity rate was 1.3%. Older age, higher educational attainment, and reaching various transition milestones were among the strongest predictors of lifetime HIV testing. Risk factors for being HIV-positive included gender identity (female), race (African American), age (middle-aged), and educational attainment (lower).
Conclusions: Rates of HIV testing are low among transgender adults, and among those tested, the likelihood of being HIV-positive is much greater than in the population-at-large. Certain subpopulations of transgender individuals are much more likely than others to report never having been tested for HIV and/or to say that they had tested positive for HIV. Substantial evidence was found for the presence of syndemic-type effects influencing both the likelihood of having been tested for HIV and the odds of testing HIV-positive.