TY - JOUR
T1 - Prevalence of and Factors Associated with Genital and Extragenital Chlamydia and Gonorrhea among Transgender Women in HIV Care in the United States, 2005 to 2016
AU - Van Gerwen, Olivia T.
AU - Tamhane, Ashutosh
AU - Westfall, Andrew O.
AU - Mugavero, Michael J.
AU - Crane, Heidi M.
AU - Moore, Richard D.
AU - Karris, Maile
AU - Christopoulos, Katerina
AU - Dombrowski, Julia C.
AU - Mayer, Kenneth H.
AU - Marrazzo, Jeanne
AU - Dionne-Odom, Jodie
N1 - Funding Information:
Background: Data on testing rates and prevalence of and factors associated with genital and extragenital chlamydia and gonorrhea among transgender women with HIV in the United States are limited. Methods: This retrospective cohort analysis included transgender women living with HIVenrolled in the US Centers for AIDS Research Network of Integrated Clinical Systems cohort between January 2005 and December 2016 with chlamydia or gonorrhea testing performed in HIV clinic. The primary outcome was a positive test result for chlamydia or gonorrhea at urogenital or extragenital (rectal/pharyngeal) sites. Factors associated with infection were examined using logistic regression and generalized estimating equations to account for multiple tests per woman. Results: Among 312 transgender women in HIV care, 252 (81%) were tested for chlamydia or gonorrhea at least once. Annual testing rates were low: 23% to 53% at genital sites and 24% to 47% at extragenital sites. A total of 88 infections were detected, and 22% of women (55/252) had at From the *Department of Medicine, Division of Infectious Diseases, Uni-versity of Alabama at Birmingham, Birmingham, AL; †Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA; ‡Department of Medicine, Division of In-fectious Diseases, Johns Hopkins University, Baltimore, MD; §Depart-ment of Medicine, Division of Infectious Diseases, University of California at San Diego, San Diego; ¶Department of Medicine, Divi-sion of Infectious Diseases, University of California at San Francisco, San Francisco, CA; and ||Fenway Health and Department of Medicine, Division of Infectious Diseases, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA Conflict of Interest and Sources of Funding: K.C. has received investigator-initiated grant support from Gilead Sciences and has served as a medical advisory board member for Gilead. J.C.D. has conducted research funded by Hologic. All other authors have no relevant disclosures.
Publisher Copyright:
© Lippincott Williams & Wilkins.
PY - 2021
Y1 - 2021
N2 - Background Data on testing rates and prevalence of and factors associated with genital and extragenital chlamydia and gonorrhea among transgender women with HIV in the United States are limited. Methods This retrospective cohort analysis included transgender women living with HIV enrolled in the US Centers for AIDS Research Network of Integrated Clinical Systems cohort between January 2005 and December 2016 with chlamydia or gonorrhea testing performed in HIV clinic. The primary outcome was a positive test result for chlamydia or gonorrhea at urogenital or extragenital (rectal/pharyngeal) sites. Factors associated with infection were examined using logistic regression and generalized estimating equations to account for multiple tests per woman. Results Among 312 transgender women in HIV care, 252 (81%) were tested for chlamydia or gonorrhea at least once. Annual testing rates were low: 23% to 53% at genital sites and 24% to 47% at extragenital sites. A total of 88 infections were detected, and 22% of women (55/252) had at least one positive test result. Most infections occurred at extragenital sites (80% of chlamydia and 82% of gonorrhea positive test results). Factors associated with infection in an adjusted model were as follows: age 18 to 29 years compared with =50 years (adjusted odds ratio [aOR], 7.6; 95% confidence interval [CI], 1.8-31.2), CD4 count >350 compared with CD4 <200 (aOR, 5.5; 95% CI, 1.2-25.1), and higher engagement in HIV care (aOR, 2.2; 95% CI, 1.0-4.5). Conclusions Among transgender women living with HIV, testing rates for chlamydia and gonorrhea are inadequate, particularly at extragenital sites where most infections occur.
AB - Background Data on testing rates and prevalence of and factors associated with genital and extragenital chlamydia and gonorrhea among transgender women with HIV in the United States are limited. Methods This retrospective cohort analysis included transgender women living with HIV enrolled in the US Centers for AIDS Research Network of Integrated Clinical Systems cohort between January 2005 and December 2016 with chlamydia or gonorrhea testing performed in HIV clinic. The primary outcome was a positive test result for chlamydia or gonorrhea at urogenital or extragenital (rectal/pharyngeal) sites. Factors associated with infection were examined using logistic regression and generalized estimating equations to account for multiple tests per woman. Results Among 312 transgender women in HIV care, 252 (81%) were tested for chlamydia or gonorrhea at least once. Annual testing rates were low: 23% to 53% at genital sites and 24% to 47% at extragenital sites. A total of 88 infections were detected, and 22% of women (55/252) had at least one positive test result. Most infections occurred at extragenital sites (80% of chlamydia and 82% of gonorrhea positive test results). Factors associated with infection in an adjusted model were as follows: age 18 to 29 years compared with =50 years (adjusted odds ratio [aOR], 7.6; 95% confidence interval [CI], 1.8-31.2), CD4 count >350 compared with CD4 <200 (aOR, 5.5; 95% CI, 1.2-25.1), and higher engagement in HIV care (aOR, 2.2; 95% CI, 1.0-4.5). Conclusions Among transgender women living with HIV, testing rates for chlamydia and gonorrhea are inadequate, particularly at extragenital sites where most infections occur.
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U2 - 10.1097/OLQ.0000000000001335
DO - 10.1097/OLQ.0000000000001335
M3 - Article
C2 - 33229965
AN - SCOPUS:85106540174
VL - 48
SP - 410
EP - 416
JO - Sexually Transmitted Diseases
JF - Sexually Transmitted Diseases
SN - 0148-5717
IS - 6
ER -