HIV Testing Frequencies and Correlates in a Statewide Sample of Transgender, Nonbinary, and Intersex Adults in the United States

Although transgender, nonbinary, and intersex (TNI) people are at greater risk for HIV acquisition than their cisgender counterparts, the research on HIV testing frequencies and predictors in this population is limited. Research focused on identifying HIV testing differences by gender among TNI people is especially lacking. This secondary data analysis examined differences in HIV testing frequencies by gender and identified the factors significantly associated with lifetime and recent HIV testing in a statewide convenience sample of TNI adults in the Mountain West region of the United States. Although chi-square test results indicated no significant gender differences in lifetime HIV testing, a significantly smaller proportion of nonbinary individuals reported receiving an HIV test in the last year when compared with transmasculine, transfeminine, and intersex individuals (Fisher's exact <i>p</i> = 0.04). Multi-variable logistic regression results revealed that having to educate medical providers about transgender-related care was significantly associated with a higher likelihood of ever receiving an HIV testing (<i>AOR</i> = 2.82, 95% CI (confidence interval): [1.56-5.07], <i>p</i> < 0.01). Moreover, nonbinary individuals were significantly less likely to have received an HIV test in the last year (<i>AOR</i> = 0.30, 95% CI: [0.11-0.81], <i>p</i> < 0.05). These findings point to the potentially important role that provider factors may play in HIV testing for TNBI persons. Alongside recognition of the need for more empirical work to understand complex relationships identified in this study, the study results suggest that HIV testing efforts may need to focus more on expanding access to TNI individuals, including those who identify as nonbinary.