Transgender Women Are Less Likely to Adhere to ART, Hormone Therapy

Concerns about interactions between hormone therapy (HT) and antiretroviral therapy (ART) are a reason for the lack of adherence to HT and ART among transgender women, according to a recent study presented at the International Aids Society Conference on HIV Science.

The study included 87 transgender women (62% Hispanic, mean age 45 years) who were enrolled in the APAIT study. Sociodemographics, medical history, and knowledge of ART-HT drug-drug interactions were reported by participants.

Overall, 69% of participants were taking HT, and 54% of participants had HIV. All participants with HIV were on ART, 40% of whom reported being on integrase inhibitor-based ART, 32% reported being on a protease inhibitor-based ART, and 28% reported being on a non-nucleoside reverse-transcriptase inhibitor-based ART.

While 77% of participants reported having a regular healthcare provider, only 68% discussed potential HT side effects with their provider (78% of participants without HIV and 61% of participants with HIV), and 25% reported unsupervised HT (13% of participants without HIV and 34% of participants with HIV).

Concerns for ART-HT interactions were reported by 57% of participants who were HIV positive. However, only 49% discussed ART-HT drug-drug interactions with their provider. In addition, 40% cited the concern for ART-HT drug-drug interactions as a reason for not taking ART, HR or both as directed (n=5, 5, and 7, respectively).

“Transgender women frequently have concerns about potential ART and HT side effects and [drug-drug interactions] that, coupled with sub-optimal provider engagement, contribute to both ART and HT non-adherence,” the researchers concluded. “Improved clinician and patient engagement and education are needed to address these concerns and optimize care for transgender women.”

“Future research will address ART-HT interactions and side effect risk for transgender women, and investigate approaches to mitigate risk.”

—Melissa Weiss

Reference:

Braun HM, Candelario J, Hanlon CL, et al. High levels of treatment non-adherence due to concerns for interactions between antiretroviral therapy and feminizing hormones among transgender women in Los Angeles, CA. Presented at: 9th IAS Conference on HIV Science; July 23-26, 2017; Paris, FR. Abstract 1818. http://programme.ias2017.org/Abstract/Abstract/1818.