Structural factors associated with viral suppression among transgender women with HIV in France

作者：Margot Annequin, Marion Mora, Raymond van Huizen, Aissatou Faye, Marion Fiorentino, Christel Protière, Michel Bourrelly, Gwenaëlle Maradan, Cyril Bérenger, F. Michard, Yazdan Yazdanpanah, Anaenza Freire Maresca, É. Rouveix, Liam Bahlan, Marie Costa, David Michels, Laszlo Blanquart, Giovanna Rincon, Bruno Spire, and the ANRS-Trans&HIV study group · 发表于：AIDS · 年份：2025 · DOI：10.1097/qad.0000000000004337 · 被引用次数：2 · 研究领域：HIV/AIDS Research and Interventions、Viral-associated cancers and disorders、LGBTQ Health, Identity, and Policy

OBJECTIVE: France provides universal health coverage to all residents, including undocumented migrants. Most transgender women with HIV (TWH) in France are migrants from Latin America. This study aimed to describe the rate of viral suppression among TWH in France and identify structural factors influencing this outcome. DESIGN: Trans&HIV is a French, nationwide, cross-sectional, retrospective life-event survey and community-based research study conducted between August 2020 and June 2022. Community-based interviewers recruited and administered questionnaires to 536 TWH in 36 different HIV care units. METHODS: We calculated the rate of viral suppression in TWH on antiretroviral therapy (ART) for at least 1 year using data from medical records, and identified associated structural factors, adjusting for clinical factors, using Firth's penalized logistic regression. RESULTS: Of the 506 participants with complete data, 86% were non-French nationals, most (83%) were born in Latin America. Thirty percent of participants were undocumented and 75% did not have gender-concordant identity documents. Eighty-eight percent ( N = 486) had achieved viral suppression. After adjustment for clinical factors, structural factors negatively associated with viral suppression included a lack of healthcare coverage [aOR = 3.32, 95% confidence interval (95% CI) 1.23-8.66] and not having gender-concordant identity documents [aOR = 2.05, 95% CI (1.00-4.64)]. TWH receiving state medical assistance for u...