Experiences of gender-affirming practices in healthcare settings and HIV testing among transgender and nonbinary young adults in the United States

Transgender and nonbinary young adults in the United States (U.S.) experience disproportionately high rates of HIV and face unique barriers to accessing HIV testing, a key component of HIV prevention. Gender-affirming practices in healthcare settings may improve care access and reduce care avoidance among transgender and nonbinary people. To our knowledge, no study has examined the association between gender-affirming practices in healthcare settings and HIV testing among transgender and nonbinary U.S. young adults. This study analyzed national cross-sectional, online data from transgender and nonbinary U.S. young adults aged 18-30 years (N = 225) to assess the association between the gender affirmation sub-scale of the Transgender and Gender Diverse Healthcare Discrimination and Adverse Experiences Scale (range: 0-20) and past-year HIV testing using multivariable logistic regression. We found that a one-point increase in the gender affirmation sub-scale score was positively associated with past-year HIV testing (odds ratio = 1.15; 95% confidence interval: 1.06, 1.26), adjusting for age, geographic region, gender identity, educational attainment, employment status, having a usual source of care, and health insurance status. Our findings provide additional evidence that access to gender-affirming healthcare settings is important in facilitating utilization of preventive services among transgender and nonbinary U.S. young adults.