Introduction
Hepatitis C virus (HCV) prevalence among transgender and gender-diverse individuals
ranges from 1.8% to 15.7% versus 1% in the general population. Previous HCV studies
inclusive of transgender and gender-diverse individuals primarily rely on convenience-based
sampling methods or are geographically restricted. The purpose of this study is to
compare the prevalence of HCV diagnoses, testing, and care engagement between transgender
and gender-diverse and cisgender individuals.
Methods
Using Optum's de-identified Clinformatics® Data Mart Database, in 2022, the unadjusted
prevalence of HCV testing among all adults and people who inject drugs from January
2001 to December 2019 was measured. Multivariable logistic regression was used to
compare the adjusted odds of HCV diagnoses and care engagement by gender subgroup.
Results
The overall unadjusted frequency of HCV diagnoses among transgender and gender-diverse
individuals was approximately 3 times that of cisgender individuals (1.06% vs 0.38%,
p<0.001), including among people who inject drugs (6.36% vs 2.36%, p=0.007). Compared with cisgender women, transfeminine/nonbinary individuals had over
5 times the adjusted odds of a HCV diagnosis and approximately 3.5 times the odds
of being tested for HCV. In addition, compared with cisgender women, transfeminine/nonbinary
individuals had significantly increased odds of having a HCV‒related procedure (e.g.,
abdominal ultrasounds, liver biopsies, Fibroscans). Cisgender men had significantly
increased odds of receiving HCV medication compared with cisgender women.
Conclusions
Although testing was higher among transgender and gender-diverse individuals, the
higher overall frequency of HCV diagnoses among transgender and gender-diverse than
among cisgender individuals signals persistent health disparities. Interventions are
warranted to prevent HCV and increase ongoing testing and treatment uptake among transgender
and gender-diverse populations.
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Article info
Publication history
Published online: February 08, 2023
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Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
