Depression, sexual behavior, and HIV treatment outcomes among transgender women, cisgender women and men who have sex with men living with HIV in Brazil and Thailand: a short report

AIDS Care. 2020 Mar;32(3):310-315. doi: 10.1080/09540121.2019.1668526. Epub 2019 Sep 17.


One in five transgender women (TW) are living with HIV, yet little has been published about their health outcomes. We analyzed data from TW (n = 37), cisgender women (CW, n = 165), and cisgender men who have sex with men (MSM, n = 151) in Thailand and Brazil. We hypothesized: (1) TW will have higher odds of depressive symptoms, lower odds of condom use and greater odds of a detectable viral load compared to MSM and CW; and (2) TW will have lower odds of condom use and higher odds of detectable viral load. We found that TW had higher odds of depression (OR 2.2, 95%CI: 1.0, 4.8, p = 0.04) and were less likely than MSM (22% v. 42%, p = 0.01) to use condoms with partners of unknown serostatus. In multivariable models, TW had lower odds than MSM of using condoms with partners with unknown serostatus (OR 0.38, 95%CI: 0.15, 0.90) and CW had lower odds than MSM of using condoms with HIV-negative partners (0.60 [0.38, 0.95], p = 0.029). We found no significant differences in detectable viral load. Disaggregating data by gender is important to understand factors that contribute to viral suppression and HIV transmission risk among people living with HIV.

Keywords: Brazil; HIV; HPTN; Thailand; Transgender; depression.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Brazil / epidemiology
  • Condoms
  • Depression / ethnology
  • Depression / psychology*
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / ethnology
  • HIV Infections / virology
  • Homosexuality, Male / ethnology
  • Homosexuality, Male / psychology*
  • Humans
  • Male
  • Sexual Behavior / ethnology
  • Sexual Behavior / psychology*
  • Sexual Partners
  • Sexual and Gender Minorities
  • Thailand / epidemiology
  • Transgender Persons / psychology*
  • Treatment Outcome
  • Viral Load
  • Young Adult


  • Anti-HIV Agents