Sexual health for trans women with HIV
Differences in sexual health and wellbeing among women living with HIV are under-explored. Limited research is available, however, what is out there suggests that women living with HIV who identify as a sexual minority may experience barriers to HIV care. Cross-sectional baseline data was analyzed from a Canadian cohort study with women living with HIV (sexual minority women: n=180; heterosexual women: n = 1240). Women identifying as belonging to a sexual minority (median age 38 years, IQR 13) included bisexual (58.9%), lesbian (17.8%) and other sexualities (23.3%). In multivariable analyses adjusting for age, poverty, education, and ethnicity, women identifying as belonging to a sexual minority were associated with increased odds of: clinical (80% vs. 100% antiretroviral adherence), intrapersonal (previous/current injection drug use [IDU] vs. no IDU history, depression, lower resilience), interpersonal (childhood abuse, sex work, adulthood abuse), and structural (HIV support services barriers, unstable housing, racial discrimination, gender discrimination) factors in comparison with women who identified as heterosexual. Women living with HIV who identify as belonging to a sexual minority category experience social and health disparities relative to heterosexual women living with HIV, highlighting the need for interventions to promote health equity.