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Research Gaps in Drug Interactions Raise Concerns for Transgender Women With HIV

“Despite all indications that transgender women are a critical population in HIV care, very little is known about how to optimize co-administration of ART and hormonal therapies in this population,” said Jordan Lake, MD, in the in a press release. Lake is a study leader at the University of California, Los Angeles David Geffen School of Medicine, and is conducting relevant research at the University of Texas Health Sciences Center at Houston. “This study suggests this void of information may mean some transgender women forgo life-sustaining HIV medications, identity-affirming hormone therapy, or some combination of the two. By exploring the extent to which this is happening, we can find ways to better serve this population.”

The use of ART quickly and consistently following HIV infection is important in preventing early onset of AIDS-related complications. ART also improves other aspects of health and can contribute to extending life expectancy. Consistent use also limits the likelihood of transmitting the virus to sexual partners. Despite the positive outcomes that occur from using ART, there is very little information about the therapy’s reaction with hormone therapy.

The concerns about drug interactions between ART and HT are possibly related to the drug interactions between types of ART and types of hormonal contraceptives, which may be similar to components of HT. ART can lower the effectiveness of certain hormonal contraceptives, but if this occurs, a simple dose modification or drug substitution can be effective. However, NIH indicates that there not an accepted scientific conclusion about the safety and effectiveness of combining ART and HT in transgender women with HIV.

“Making sure we are meeting the needs of transgender women living with HIV is key to addressing this pandemic,” said Judith Currier, MD, co-director of the Center for AIDS Research and Education at the University of California, Los Angeles, co-investigator and vice-chair of the NIAID-supported AIDS Clinical Trials Network. “We need to provide an evidence-based response to these understandable concerns so that this key population and their sexual partners may reap the full benefits of effective HIV care.”
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