HIV and Transgender People: Viral Suppression

Viral suppression is the percentage of people with diagnosed HIV who have less than 200 copies of HIV per milliliter of blood.

EHE goal: increase the percentage of people with HIV who have are virally suppressed to 95 percent by 2025.
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It is important for transgender people to know their HIV status so they can take medicine to treat HIV if they have the virus. Taking HIV medicine every day can make the viral load undetectable. People who get and keep an undetectable viral load (or remain virally suppressed) can stay healthy for many years and will not transmit HIV to their sex partners.

Transgender People with Diagnosed HIV in 44 States and the District of Columbia, 2019
Compared to all people, transgender women have about the same viral suppression rates, and transgender men have higher viral suppression rates.
This graphic shows the proportion of transgender women and transgender men with diagnosed HIV who received some HIV care, were retained in care, and were virally suppressed.
This graphic shows the proportion of transgender women and transgender men with diagnosed HIV who received some HIV care, were retained in care, and were virally suppressed.
For comparison, for every 100 people overall with diagnosed HIV, 76 received some care, 58 were retained in care, and 66 were virally supressed.

* Had 2 viral load or CD4 tests at least 3 months apart in a year.
Had less than 200 copies of HIV per milliliter of blood on most recent viral load test.
Source: CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 Dependent Areas, 2019. HIV Surveillance Special Report 2021; 26(2).

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Although many people taking HIV medicine are virally suppressed, some people with HIV who are taking HIV medicine are currently not virally suppressed or do not maintain viral suppression over time. Some challenges with achieving and maintaining viral suppression include missing multiple doses of HIV treatment, missing medical appointments, or needing other important health care services.

Missed HIV Medical Care Appointments Among Transgender People with Diagnosed HIV in the US, 2019*
Staying in HIV care is important to achieving and maintaining viral suppression.
43 percent of transgender people and 24 percent of people overall missed at least 1 in the past 12 months.

* Among people aged 18 and older.
Source: CDC. Medical Monitoring Project.

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HIV Treatment Among Transgender People with Diagnosed HIV in the US, 2019*
Taking HIV medicine consistently and as prescribed is the best way to achieve and maintain viral suppression.
54 percent of transgender people and 59 percent of people overall reported taking all their doses of HIV medicine over the last 30 days.

* Among people aged 18 and older.
Source: CDC. Medical Monitoring Project.

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Needed HIV Ancillary Care Services Among Transgender People with Diagnosed HIV in the US, 2019*†
HIV ancillary care services are essential for supporting people in staying in HIV care and maintaining viral suppression.
The top ancillary care service transgender people with HIV reported needing in 2019 was dental care, with 22 percent saying they needed but did not receive it.
Nearly half of all people with HIV needed at least 1 HIV ancillary care service in the past 12 months.

*  Among people aged 18 and older.
† HIV ancillary care services, such as case management and mental health services, are services that support retention in HIV care.
Source: CDC. Medical Monitoring Project.

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Social and economic issues—such as homelessness, depression, and stigma—have prevented some transgender people from getting the HIV care and treatment they need. These factors make it difficult for some transgender people with HIV to achieve and maintain viral suppression.

Homelessness Among Transgender People with Diagnosed HIV in the US, 2019*
People who experience homelessness may find it difficult to get HIV care and treatment.
15 percent of transgender people and 10 percent of reported homelessness in the past 12 months.

* Among people aged 18 and older.
Source: CDC. Medical Monitoring Project.

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Symptoms of Depression and Anxiety Among Transgender People with Diagnosed HIV in the US, 2019*
Some transgender people with diagnosed HIV may have difficulty getting treatment for depression and anxiety.
27 percent of transgender people and 22 percent of people overall reported depression and anxiety in the past 12 months.

* Among people aged 18 and older.
Source: CDC. Medical Monitoring Project.

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Median HIV Stigma Score Among Transgender People with Diagnosed HIV in the US, 2019*
Transgender people with diagnosed HIV experience higher HIV stigma.

* Among people aged 18 and older.
Median HIV stigma scores are presented on a ten-item scale ranging from 0 (no stigma) to 100 (high stigma) that measures personalized stigma, disclosure concerns, negative self-image, and perceived public attitudes about people with HIV.
Source: CDC. Medical Monitoring Project.

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Deaths

In 2019, there were 141 deaths among transgender people with diagnosed HIV in the US and dependent areas. These deaths could be from any cause.

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