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Incidence of Human Immunodeficiency Virus Among Male-to-Female Transgendered Persons in San Francisco

Kellogg Timothy A.; Clements-Nolle, Kristen; Dilley, James; Katz, Mitchell H.; McFarland, William
JAIDS Journal of Acquired Immune Deficiency Syndromes: December 1st, 2001
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Objective:To estimate HIV incidence among male-to-female transgendered persons (MtF transgendered persons) who repeatedly tested for HIV antibodies at public San Francisco counseling and testing sites between July 1997 and June 2000.

Methods:HIV seroconversions were identified and person-time of observation were estimated using the date and result of the current test and the self-reported date and result of the previous test. Factors independently associated with HIV seroconversion were determined using multivariable proportional hazard analysis.

Results:HIV incidence was 7.8 per 100 person-years (95% confidence intervals [CI], 4.6-12.3) based on 13 seroconversions among 155 repeat testers with 167.7 person-years of observation. African-American race/ethnicity (adjusted relative hazard ratio [HR], 5.0; 95% CI, 1.5-16.2) and unprotected receptive anal intercourse (HR, 3.9; 95% CI, 1.2-13.1) were independent predictors of HIV seroconversion.

Conclusions:HIV is currently spreading at an extremely high rate among MtF transgendered persons in San Francisco, especially those who are African Americans.

Address correspondence and reprint requests to Timothy A. Kellogg, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102 U.S.A.; e-mail:

Manuscript received April 18, 2001; accepted August 20, 2001.

© 2001 Lippincott Williams & Wilkins, Inc.