Elsevier, Social Science and Medicine, Volume 230, June 2019
Rationale: Transgender people face unique challenges, such as structural, interpersonal, and individual vulnerabilities to chronic diseases. Stigma and prejudice may hamper their access to health care and prevent their inclusion in the labor market, as well as cause exposition to violence. Labor market exclusion contributes to engagement in survival sex work, which increases HIV infection vulnerability. HIV continuum of care combines HIV prevention (including antiretroviral pre-exposure prophylaxis (PrEP), antiretroviral post-exposure prophylaxis (PEP) and HIV testing) with linkage to care (that is, initiating, maintaining and monitoring antiretroviral therapy). Currently, many studies evaluate the access barriers and facilitators to HIV care for transgender people. Objective: The present systematic review aimed to provide a clear summary of the current literature on HIV-related care for transgender men, transgender women and gender diverse people. Method: Inclusion criteria were peer-reviewed quantitative studies, published through April 04, 2018, concerning transgender women, transgender men and gender diverse people and HIV-related care, which was any intervention aiming to prevent, treat or alleviate the impact of HIV on these populations. Results: From 6,585 references, 62 articles were included: Three articles had results on PEP, 18 on PrEP, 29 on HIV-testing, 17 on access to health care, and 13 on adherence to treatment. Conclusions: The present study is the first systematic review evaluating HIV-related care for transgender people. Data collection is still scarce regarding transgender men and gender diverse people. Worldwide, testing for HIV infection does not necessarily enable access to the HIV continuum of care for transgender populations or even guarantee awareness of HIV seropositivity.
Access To Health Services; Adherence To Treatment; Anti Human Immunodeficiency Virus Agent; Anti-HIV Agents; Antiretrovirus Agent; Disease Treatment; Female; Female To Male Transgender; Gender Diverse People; Gender Role; Global Health; HIV Infections; HIV Testing; Health Care; Health Care Access; Health Care Delivery; Health Services; Health Services Accessibility; Human; Human Immunodeficiency Virus; Human Immunodeficiency Virus Infection; Humans; Literature Review; Male; Male To Female Transgender; Medication Compliance; PEP; Patient Acceptance Of Health Care; Patient Attitude; Patient Care; Patient Compliance; Peer Review; Post Exposure Prophylaxis; PrEP; Pre-exposure Prophylaxis; Quantitative Study; Review; Social Stigma; Systematic Review; Transgender; Transgender Men; Transgender Persons; Transgender Women; Global