Treatment as Prevention (TasP) among black transgender women (BTW) in the United States: characterizing the HIV care continuum and identifying correlates of HIV diagnosis and care

Public Health Significance: Treatment as prevention (TasP) could be an effective way to address the HIV epidemic among Black transgender women (BTW) in the United States. For TasP to be effective in this population, more information regarding the manifestation of HIV care continuum outcomes among BTW is needed. Methods: Data came from Promoting Our Worth, Equality, and Resilience (POWER). In 2014 and 2015, POWER recruited Black men who have sex with men (BMSM) and BTW who attended Black Pride events in Philadelphia, PA, Houston, TX, Washington, D.C., Detroit, MI, Memphis, TN, and Atlanta, GA. A total of 245 BTW provided complete data for our analysis. Results: We detected an HIV prevalence rate of 37.8%. Of the 92 HIV-positive BTW, 50% had prior knowledge of their HIV-positive status. 100% of those with prior knowledge of their HIV-positive status reported that they were linked to HIV medical care. 93% of HIV-positive BTW linked to HIV medical care reported that they were retained in HIV medical care, and 95% of those retained in HIV medical care reported that they had been prescribed antiretrovirals (ARVs). 68% of the 41 HIV-positive BTW prescribed ARVs reported that they had an undetectable viral load. Health outcomes associated with HIV care in other populations were not associated with HIV diagnosis or viral suppression in our sample. Conclusion: Developing and implementing interventions that address testing uptake may assist in informing the HIV disparity among BTW in the United States. More research is needed to identify and understand the structural, community, and individual-level barriers and facilitators that shape BTW’s engagement in HIV medical care.