Transgender and gender diverse (TGD) adults in the United States experience health disparities, especially in HIV infection. TGD women have an estimated 21.7% laboratory-confirmed HIV prevalence (meta-analysis), 34.2-fold higher odds than in the US population. Medical gender affirmation (GA), such as hormone replacement therapy and surgeries, is known to be medically necessary and to improve health. Few studies have assessed the effect of medical GA on the HIV prevention continuum (eg, preexposure prophylaxis [PrEP] uptake), the HIV care continuum (eg, virological suppression), and sexually transmitted infection (STI) diagnoses.
