Drug Use is Associated with Delayed Advancement Along the HIV Care Continuum Among Transgender Women of Color

  • Cathy J. RebackEmail author
  • Dennis Rünger
  • Jesse B. Fletcher
Original Paper


Transgender women are impacted by elevated rates of HIV infection and drug use. This study investigated effects of drug use on HIV care outcomes among transgender women of color living with HIV who enrolled in a combined peer health navigation (PHN) and contingency management intervention (N = 129). At baseline, 71.3% reported any drug use in the past 6 months. Linkage to HIV care was delayed for users of any stimulant compared to non-users of stimulants, and for methamphetamine users compared to non-users of methamphetamine. Any drug use, relative to no drug use, was associated with fewer HIV care visits (IRR 0.50, 95% CI [0.30, 0.85]), but did not significantly impact ART adherence, or attaining an undetectable viral load. PHN sessions were positively related to the number of HIV care visits (IRR 1.20, 95% CI [1.07, 1.34]), especially for users of any stimulant and for methamphetamine users, to ART adherence (OR 2.54, 95% CI [1.67, 3.86]), and to virological suppression (OR 7.57, 95% CI [1.64, 34.94]). These findings demonstrate the value of assessing drug use as a possible barrier to HIV care.


Transgender Drug use HIV care continuum ART adherence 



This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number H97HA24968 in the last annual award amount of $285,757 awarded to Friends Research Institute (PI: C. Reback). No percentage of this project was financed with non-governmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. Dr. Reback acknowledges additional support from the National Institute of Mental Health (P30 MH58107).


Funding was provided by Health Resources and Services Administration (Grant No. H97HA24968), National Institute of Mental Health (Grant No. P30 MH58107).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Friends Research Institute, Inc.Los AngelesUSA
  2. 2.Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesUSA
  3. 3.Center for HIV Identification, Prevention and Treatment ServicesUniversity of California, Los AngelesLos AngelesUSA

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