Nonuptake of HIV Testing Among Transgender Populations in the United States: Results from the 2015 U.S. Transgender Survey

Babayemi O Olakunde; Jennifer R Pharr; Daniel A Adeyinka; Donaldson F Conserve

doi:10.1089/trgh.2020.0141

Nonuptake of HIV Testing Among Transgender Populations in the United States: Results from the 2015 U.S. Transgender Survey

Transgend Health. 2022 Oct 7;7(5):430-439. doi: 10.1089/trgh.2020.0141. eCollection 2022 Oct.

Authors

Babayemi O Olakunde¹, Jennifer R Pharr¹, Daniel A Adeyinka², Donaldson F Conserve³

Affiliations

¹ Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA.
² Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.
³ Department of Prevention and Community Health, Milken Institute of Public Health, George Washington University, Washington, District of Columbia, USA.

Abstract

Purpose: In this study, we examined the nonuptake of HIV testing and the main reasons for never testing among transgender populations.

Methods: Data on 26,927 respondents from the 2015 U.S. Transgender Survey were analyzed in this study. The main reasons for never testing were categorized as low risk perception; access related; fear or HIV-related stigma; and others. We performed weighted descriptive statistics and multivariable logistic regression analyses, controlling for sociodemographic characteristics and sexual orientation.

Results: Forty-five percent of the respondents had never tested for HIV. Trans women (adjusted odds ratio [aOR]=1.1, 95% confidence interval [CI]=1.07-1.25) and assigned female at birth genderqueer/nonbinary individuals (AFAB GQ/NB) (aOR=1.3, 95% CI=1.16-1.35) had significantly higher odds of reporting never testing for HIV compared with trans men. The most reported reason for never testing was low risk perception (87%). AFAB GQ/NB (aOR=1.4, 95% CI=1.22-1.66) had significantly higher odds of reporting low risk perception as the main reason for never testing for HIV relative to trans men. AFAB GQ/NB were less likely to report access related as the main reason for never testing (aOR=0.8, 95% CI=0.56-0.95). The odds of trans women and assigned male at birth GQ/NB individuals reporting fear or HIV-related stigma as the main reason for never testing were 1.7 (95% CI=1.13-2.55) and 2.8 (95% CI=1.69-4.70) times that of trans men. Both trans women (aOR=0.8, 95% CI=0.65-0.97) and AFAB GQ/NB (aOR=0.7, 95% CI=0.60-0.88) had lower odds of reporting others. The main reasons for never testing also varied by sociodemographic factors, including age, educational attainment, race/ethnicity, employment status, poverty, and sexual orientation.

Conclusions: HIV testing is suboptimal among transgender populations. Our findings also suggest that barriers to HIV testing vary by transgender populations, thus interventions for improved uptake should be population specific.

Keywords: HIV/AIDS; barriers; gender minority; screening.