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This investigation delved into the disparities in HIV prevalence and prevention among transgender individuals in the United States. While transgender youth showed higher rates of HIV testing, they were less likely to receive HIV education and use condoms compared to their non-transgender peers.

HIV in the United States disproportionately affects transgender individuals. A recent report from the Centers for Disease Control and Prevention (CDC) shows the prevalence of HIV in transgender people at 42%, compared to a national prevalence of 0.32%. It is vital to understand the reasons for such a significant health disparity in order to determine how to improve HIV prevention for transgender people. For example, while condom use is a key contributor to risk reduction, lower condom use has been noted among transgender individuals. Poor HIV education might also contribute.

Earlier studies using 2009–2017 data from the National Youth Risk Behavior Survey (YRBS) have identified some contributing factors to these disparities. A new study published in the journal Health Education & Behavior used 2019 YRBS data with an initial sample of 138,783 high school-aged youth.

HIV Prevention and Disparities: Transgender vs. Cisgender

The study found that both female and male transgender individuals were more likely to be tested for HIV compared to their non-transgender peers. In total, 14.6% of non-transgender females and 15.5% of non-transgender males tested for HIV, compared to 24.2% of transgender females and 31.3% of transgender males. 

However, transgender people were significantly less likely to receive HIV education compared to those who were not transgender. Similarly, transgender individuals were less likely to use condoms than non-transgender individuals. Condom use in transgender males was reported at 45.2%, compared to 65.9% in non-transgender males. Condom use in transgender females was 40.3%, compared to 54.5% in non-transgender females. 

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The Bottom Line

The study did have some unexpected findings. Contrary to expectations, transgender youth were almost twice as likely to undergo HIV testing as their non-transgender peers This could be a result of improving education and messaging encouraging transgender people to get tested. However, higher testing rates are only possible when there is no widespread transphobia. Researchers say that any policy change, like those involving hormone replacement therapy in transgender individuals, may reverse these outcomes. 

Though there were differences in HIV education, they were more significant among males. Finally, the findings regarding condom use were consistent with earlier studies showing that there is still a need to address the root cause of low condom use by transgender individuals. Hence, the study concluded that there is a need for providing culturally appropriate HIV education and improving access to HIV prevention tools like condoms.


Phillips, G., Davoudpour, S., Floresca, Y. B., Felt, D., Curry, C. W., Wang, X., Choi, J., Kelsey, S. W., & Beach, L. B. (2022). Disparities in HIV testing, condom use, and HIV education between transgender and not transgender High School–Aged youth: Findings from the 2019 Youth Risk Behavior Survey. Health Education & Behavior, 50(1), 29–40. https://doi.org/10.1177/10901981221142238