Successful program on prevention, diagnosis, and access to clinical care and treatment for transgender population in an HIV clinic of Buenos Aires. Sequencial study
J. Toibaro1, G. Viloria1, M. Bullo1, J. Ebensrtejin1, P. Burgoa1, A. Parlante1, A. Freyre2, M. Romero3, M. Losso1
1Hospital General de Agudos José M Ramos Mejía, Servicio de Inmunocomprometidos, Buenos Aires, Argentina, 2Fundacion Buenos Aires Sida, Buenos Aires, Argentina, 3Asociación de Travestis, Transgénero y Transexuales de la Argentina, Buenos Aires, Argentina
Background: Transgender population has been identified as a group of high prevalence of HIV-1 infection and other STIs in our setting. A Program devoted to facilitate access and address specific needs was launched on 2007, supported by the Global Fund.
Objectives: To analyze the impact and performance of the established program.
A multidisciplinary team dedicated to improve access was built with trangender community representatives (promoters), physicians, nurses, psychologists, anthropologists and pharmacists. The main strategy was to organize extramural activities to endorse the program and intramural actions to provide emotional support and guidance within the hospital circuit, including personnel and transgender promoters education. We compared transgenders who attended from 2002 to 2007 (group 1) and during the program activities (group 2) from September 2007 to June 2008. Socio-demographic data, risk factors, STIs diagnosis, HIV diagnosis, and clinical status were collected.
Results: We included 321 individuals, 163 in group 1 and 158 in group 2. There arent significant differences between groups in HIV [27.6% (45/163) vs 25.3%(40/158)]), and syphilis prevalence [42.3% (22/52) versus 55.7% (29/52)]., However, both the mean of HIV tests done and new HIV diagnosis per month increase significantly from 2.7 (group 1) to 17.5 (group 2) and 0.93 to 4, respectively. Similary, new syphilis diagnosis per month increased from 0.36 (group 1) to 3.22 (Group 2). Median CD4 cell count/mm3 (IQR) at HIV diagnosis were 295 (85.75-508.00) for group 1 and 400 (175-603) for group 2, p=0.24.
Conclusions: We confirmed that HIV and STIs prevalence in transgender people who attend our clinic is extremely high. This Program drastically improves the access of transgender persons to the health care system, including HIV and STIs diagnosis and clinical care.
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