HIV and Transgender People: Viral Suppression

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Viral suppression is one of the six Ending the HIV Epidemic in the U.S. indicators. Viral suppression refers to 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. U=U: Undetectable = Untransmittable
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, 2020*
Staying in HIV care is important to achieving and maintaining viral suppression.
31 percent of transgender people and 20 percent of all people with HIV missed at least 1 medical appointment 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, 2020*
Taking HIV medicine consistently and as prescribed is the best way to achieve and maintain viral suppression.
35 percent of transgender people and 62 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 Services Among Transgender People with Diagnosed HIV in the US, 2020*†
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 2020 was dental care, with 17 percent saying they needed but did not receive it.
Forty-one percent (41%) of all people with HIV needed, but did not receive, at least 1 HIV ancillary service in the past 12 months.

*  Among people aged 18 and older.
† HIV ancillary services, such as case management and mental health services, are services that support retention in HIV care and viral suppression.
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, 2020*
People who experience homelessness may find it difficult to get HIV care and treatment.
29% of transgender people and 8% of all people with HIV reported homelessness in the past 12 months.

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

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Depression and Anxiety Among Transgender People with Diagnosed HIV in the US, 2020*
Some transgender people with diagnosed HIV may have difficulty getting treatment for depression and anxiety.
26 percent of transgender people and 19 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, 2020*
Transgender people with diagnosed HIV experience higher HIV stigma.

* Among people aged 18 and older.
Median HIV stigma scores are presented based on a ten-item scale ranging from 0 (no stigma) to 100 (high stigma) that measures personalized stigma during the past 12 months, current disclosure concerns, current negative self-image, and current perceived public attitudes about people with HIV.
Source: CDC. Medical Monitoring Project.

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