Transgender Women Have High Rates of HIV: The Question is Why?

“Transgender women in Miami-Dade County have a disproportionately high level of HIV and other sexually transmitted diseases compared to other at-risk groups and in other areas in the US,” said Dr. Allan Rodriguez, director of Behavioral/Social Science & Community Outreach Core of the Miami Center for AIDS Research. According to statistics from the U.S. Centers for Disease Control and Prevention, about 6.34 percent of transgender women who are tested for HIV have positive results compared with 1.5 percent for other populations.

A team of University of Miami Miller School of Medicine researchers is studying why transgender women have exceptionally higher rates of acquiring HIV and other sexually transmitted infections. In a first-of-its-kind collaborative project, the LITE Study (Leading Innovation for Transgender Women’s Health and Empowerment) examines behaviors and other factors that may increase disease transmission and poor health outcomes in this diverse, at-risk population.

“We are focusing on sexual health and HIV prevention and treatment, while assessing other topics, such as gender-affirming healthcare, violence, and social support,” said Dr. Rodriguez.

“We are working closely with our community partners, TransSOCIAL, Survivors Pathway, the YES Institute, and Latinos Salud to provide participants with other types of support,” said Dr. Andrew Wawrzyniak, a University of Miami Health System psychologist and co-investigator on the study. His expertise has helped drive the focus of this study on the behavioral aspects of HIV transmission, prevention, and care.

Additionally, the study ensures linkage to care for all participants. “Transgender women in the study who test positive for HIV during the initial screening or at any point in the study will be linked to treatment,” he said.

The research team is recruiting about 250 HIV-negative transgender women for the two-year study, which includes an initial screening and follow-up visits at three, six, nine and 24 months through the UM Clinical Research Unit. Participants are routinely screened for HIV and STIs and are asked survey questions to assess sociodemographics, sexual history, general health, HIV/STI prevention and care, mental health, alcohol and drug use, social support, and resilience. Survey questions are solely delivered through a mobile device app.

“By gathering information directly from transgender women, we hope to stem the tide of new HIV infections in a population that has been underserved for a long time,” said Dr. Rodriguez. “In Miami, the majority of participants to date have been women of color, highlighting the diversity of this at-risk population.”

Prior HIV research often groups transgender women in with other populations, such as with men who have sex with men, resulting in research that does not always assess the experiences and needs that are specific to transgender women. “That has left many gaps in our knowledge about health and HIV issues that are specific to transgender women, which the current collaborative study will fill,” said Dr. Wawrzyniak.

More than 1,100 transgender women in six U.S. cities are being enrolled in LITE, the first cohort study of transgender women and transfeminine people in the United States.  Other participants in the study are Harvard University, Fenway Health, Boston Children’s Hospital, Callen-Lorde Community Health Center, Emory University, Grady Memorial Hospital, and Whitman-Walker Health.

More information on the study can be found on the LITE study website.


by Richard Westlund, contributing writer.