The Intersection of Transgender Identities, HIV, and Aging

Abstract

The Centers for Disease Control and Prevention cites the highest rates of HIV infection are found in the transgender population (Centers for Disease Control and Prevention, MMWR Morb Mortal Wkly Rep 65(40):1099–1103, 2016), yet little is known about older transgender adults with HIV. A national transgender survey reports HIV rates nearly five times those of the general US population (James et al., The report of the 2015 US transgender survey. National Center for Transgender Equality, Washington, DC, 2016). Of transgender people with HIV, around 84% are transgender women, 15% are transgender men, and 1% non-binary/other gender identity (Centers for Disease Control and Prevention, MMWR Morb Mortal Wkly Rep 65(40):1099–1103, 2016). Racial disparities are significant, with more than half of African-American transgender women HIV-infected (Centers for Disease Control and Prevention, MMWR Morb Mortal Wkly Rep 65(40):1099–1103, 2016). Approximately 3% of people with HIV aged 55 and older are transgender (Clark et al., AIDS Behavior 21:2774–2783, 2017). Transgender older adults with HIV face numerous health disparities which can be considered in the proposed Five Corners intersectionality framework. Models of care that address transgender individuals with HIV are being developed to address the unique needs of these populations. Despite these challenges, older adults with HIV and older transgender adults report high levels of resilience: an important personal resource to be leveraged in clinical care or social service programs. Providers must be prepared to competently serve the diverse population of older adults with HIV, which includes those with transgender experience.