HIV testing is necessary both to facilitate access to treatment for those living with HIV and to permit appropriate risk-reduction counseling and other interventions (e.g., PrEP or PEP) for those who are not living with HIV. Although it is estimated that one in seven Americans living with HIV is unaware of their HIV status,1 one systematic review found that fewer than half of transgender women living with HIV have been diagnosed.2
When discussing HIV testing with transgender patients, health care providers may wish to mention the following points:
- The Centers for Disease Control and Prevention (CDC) recommends HIV testing for all adults and adolescents from ages 13 to 64 at least once in their lifetimes. For higher risk groups, additional screening is recommended at least annually. Risk factors include having sex with an HIV positive partner, having more than one sex partner, injecting drugs and sharing needles, exchanging sex for drugs or money, and a STD, TB or hepatitis diagnosis.
- Early diagnosis and treatment of HIV infection significantly reduce the risk of developing AIDS or other complications of HIV infection.3 Even individuals with normal CD4 counts upon diagnosis (i.e., no evidence of a compromised immune system) benefit from antiretroviral therapy (ART).
- With treatment, people living with HIV can live longer, healthier lives and can reduce the risk of transmitting HIV to their partners. It is vital for patients to know their HIV status so those who test positive can start ART to stay healthy and minimize transmission to others, and those who test negative can take steps to remain uninfected.
HIV testing is necessary both to facilitate access to treatment for those living with HIV and to permit appropriate risk-reduction counseling and other interventions (e.g., PrEP or PEP) for those who are not living with HIV. Although it is estimated that one in seven Americans living with HIV is unaware of their HIV status,1 one systematic review found that fewer than half of transgender women living with HIV have been
- Current ART regimens are well tolerated, and several first-line regimens have no drug interactions with estrogen and anti-androgen therapies. Thus, it is possible in essentially all circumstances to find a treatment regimen for HIV that does not interfere with hormone therapy.
Engaging Partner Services
To learn more about routine HIV screening and get materials for your patients, visit the HIV Screening. Standard Care campaign. For detailed guidance on HIV testing, including the different types of HIV tests, please visit CDC’s HIV testing page. You can also read about risk reduction strategies for HIV-negative patients and HIV care.
It is estimated that 30% of new HIV infections are from those who are undiagnosed but living with the virus.4 Through Partner Services, local, county, state, and tribal health department staff help to identify and locate sex or drug-injection partners of people newly diagnosed with HIV to inform them of their risk and to provide them with testing, counseling, and referrals for other services. A 2007 systematic review showed that 20% of partners tested by Partner Services were HIV-positive.5 Providers can help engage Partner Services by reporting all new STD and HIV diagnoses to their local or regional health departments. In addition, it may be valuable to talk with patients about Partner Services and let them know that if they test positive for a reportable disease, they may be contacted by someone from the health department. It can be beneficial to emphasize the importance of participating in the Partner Services process as a way to help stop the spread of HIV and STDs.
To learn more about HIV testing, including the different types of HIV tests, please visit CDC’s HIV testing page. You can also read about risk reduction strategies for HIV-negative patients and HIV care.
- Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and six dependent areas—2013. HIV Surveillance Supplemental Report 2015;20(No. 2). Available from: http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillancereport_vol20_no2.pdf pdf icon[PDF – 6 MB]
- Herbst JH, Jacobs ED, Finlayson TJ, McKleroy VS, Neumann MS, Crepaz N; HIV/AIDS Prevention Research Synthesis Team. Estimating HIV prevalence and risk behaviors of transgender persons in the United States: a systematic review. AIDS Behav. 2008 Jan;12(1):1-17.
- INSIGHT START Study Group. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. 2015 Aug;373:795-807.
- Skarbinski J, Rosenberg E, Paz-Bailey G, Hall HI, Rose CE, Viall JH, Fagan AL, Lansky A, Mermin A. Human immunodeficiency virus transmission at each step of the care continuum in the United States. JAMA Intern Med. 2015 Apr;175(4):588-96.
- Hogben M, McNally T, McPheeters M, Hutchinson AB. The effectiveness of HIV partner counseling and referral services in increasing identification of HIV-positive individuals: a systematic review. Am J Prev Med. 2007 Aug;33(2 Suppl):S89-100.