PURPOSE:
HIV prevalence and outcome disparities among sexual
and gender minorities are profound in the United States. Tennessee HIV
surveillance practices have not been uniform for transgender status, although
data collection capabilities exist. We therefore describe current reporting of
data on transgender individuals in Tennessee to identify targets for
improvement.
METHODS:
Data for all HIV-diagnosed individuals living in
Tennessee as of December 31, 2013, were extracted from the Enhanced HIV/AIDS
Reporting System (eHARS). The birth sex ("Male" or
"Female") and current gender ("Male," "Female,"
"Male-to-Female," "Female-to-Male," or "Alternate
Gender Identity") variables were examined, and proportion missing current gender
data by region was ascertained. Transgender individuals were defined as having
different birth sex and current gender values. To ensure the protection of
health information, data were cleaned, deidentified, and aggregated using
Statistical Analysis Software (SAS) Version 9.3 (SAS Institute, Inc., Cary, NC).
RESULTS:
Among 16,063 HIV-diagnosed individuals in Tennessee,
27 were transgender: 52% (n = 14) with "Male-to-Female," 26% (n = 7)
with "Female," and 22% (n = 6) with "Male" as their current
gender values. Proportions missing current gender differed significantly by
region across Tennessee (global, P < 0.01).
CONCLUSION:
While HIV-positive transgender individuals should be
recognized as integral members of the LGBT community, they should also be
acknowledged as a separate subgroup when appropriate. Collecting information
about current self-identified gender identity should no longer be optional in
Tennessee HIV surveillance. Although making efforts to collect both birth sex
and current gender mandatory with each interview will improve surveillance, it
is critical to train all staff properly on the correct way to inquire about
gender identity in a culturally sensitive manner. Revamping data collection
methods will not only improve inconsistent methods currently in place but will
also allow staff to become more competent in asking the relevant questions and
serving transgender individuals.
11 HIV/STD/Viral Hepatitis Section , Tennessee
Department of Health, Nashville, Tennessee.
22 Vanderbilt University School of Medicine ,
Department of Medicine, Division of Infectious Diseases and Division of
Epidemiology, Nashville, Tennessee.
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