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. 2020 Jul 24;2020.07.21.20159327.
doi: 10.1101/2020.07.21.20159327. Preprint

COVID-19 Vulnerability of Transgender Women With and Without HIV Infection in the Eastern and Southern U.S

Tonia C Poteat  1 , Sari L Reisner  2   3 , Marissa Miller  4 , Andrea L Wirtz  5
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Free PMC article

COVID-19 Vulnerability of Transgender Women With and Without HIV Infection in the Eastern and Southern U.S

Tonia C Poteat et al. medRxiv. .
Free PMC article

Abstract

Background: COVID-19 is a new global pandemic and people with HIV may be particularly vulnerable. Gender identity is not reported, therefore data are absent on the impact of COVID-19 on transgender people, including transgender people with HIV. Baseline data from the American Cohort to Study HIV Acquisition Among Transgender Women in High Risk Areas (LITE) Study provide an opportunity to examine pre-COVID vulnerability among transgender women.

Setting: Atlanta, Baltimore, Boston, Miami, New York City, Washington, DC.

Methods: Baseline data from LITE were analysed for demographic, psychosocial, and material factors that may affect risk for COVID-related harms.

Results: The 1020 participants had high rates of poverty, unemployment, food insecurity, homelessness, and sex work. Transgender women with HIV (n=273) were older, more likely to be Black, had lower educational attainment, and were more likely to experience material hardship. Mental and behavioural health symptoms were common and did not differ by HIV status. Barriers to healthcare included being mistreated mistreatment, uncomfortable providers, and past negative experiences; as well as material hardships, such as cost and transportation. However, most reported access to material and social support - demonstrating resilience.

Conclusions: Transgender women with HIV may be particularly vulnerable to pandemic harms. Mitigating this harm would have positive effects for everyone, given the highly infectious nature of this coronavirus. Collecting gender identity in COVID-19 data is crucial to inform an effective public health response. Transgender-led organizations' response to this crisis serve as an important model for effective community-led interventions.

Keywords: COVID-19; HIV; health inequities; intersectionality; transgender.

Figures

Figure 1.
Figure 1.
Pre-COVID-19 Socioeconomic and Psychosocial Characteristics by Laboratory-Confirmed HIV Status at Baseline in the LITE Study
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