Top 5 Takeaways

  1. High HIV Prevalence: 38% of transgender women surveyed reported a positive HIV test, highlighting the group’s significant risk.
  2. Socioeconomic Challenges: Factors like low income, homelessness, and severe food insecurity were prevalent and negatively impacted the accessibility of HIV prevention and health care.
  3. Importance of Comfort with Health Care Providers: A comfortable relationship with health care providers was associated with better HIV-related health outcomes.
  4. Need for Gender-Affirming Care: Access to gender-affirming health care is crucial for improving HIV prevention and care among transgender women.
  5. Public Health Implications: Addressing basic needs and providing gender-affirming health care are essential steps towards better health services and HIV epidemic control.

Original Article Author and Citation

Corresponding Author

Kathryn Lee,

Suggested Citation

Lee K, Trujillo L, Olansky E, et al. Factors Associated with Use of HIV Prevention and Health Care Among Transgender Women — Seven Urban Areas, 2019–2020. MMWR Morb Mortal Wkly Rep 2022;71:673–679. DOI:


The report discusses the significant impact of socioeconomic issues and the importance of gender-affirming health care on HIV prevention and treatment among transgender women in seven U.S. urban areas. It underscores the high prevalence of HIV in this population and the various factors influencing health care access and effectiveness.


Data were collected through CDC’s National HIV Behavioral Surveillance system using respondent-driven sampling among 1,608 transgender women, with surveys and HIV testing conducted between June 2019 and February 2020. Analyses were performed using adjusted prevalence ratios to explore associations between various factors and health outcomes.


The findings reveal that socioeconomic hardships are major barriers to accessing HIV health services. However, having a trusted health care provider significantly enhances the likelihood of better health outcomes. The data also support the need for interventions targeting the specific needs of transgender women to improve health outcomes.


The study concludes that enhancing gender-affirming care and addressing socioeconomic disparities are vital to improving health care access and outcomes for transgender women, which is crucial for the efforts to end the HIV epidemic in the U.S.

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