Misinformation, Social Media, and Myths About Injectable ART: Communication Barriers to HIV Care Among Transgender Women in India

Effective health communication is vital for engagement in HIV care, especially for transgender women (TGW), who often encounter misinformation. This issue is worsened by lower literacy levels and stigma. Despite efforts like providing free antiretroviral therapy (ART), misinformation persists, and little is known about the specific rumors and misconceptions that influence TGW's engagement with HIV services. This study aims to fill these gaps and identify key intervention points to enhance HIV communication and care outcomes for TGW living with HIV. We conducted 30 in-depth interviews from July to September 2023 in Mumbai and New Delhi, India, in English, Hindi, and Marathi. Using thematic analysis with both deductive and inductive coding, we found that despite 80% of participants reporting ART adherence above 90%, misinformation remained a major barrier. Three main themes emerged: (1) misinformation about cures spread by traditional healers caused some TGW to delay or doubt ART; (2) social media, especially YouTube, served as a support source but also spread misinformation, leading to confusion; and (3) injectable ART was widely misunderstood, with some believing it to be a cure. These findings highlight the strong influence of misinformation and the need for targeted, accurate health messaging for TGW in India. Misinformation hampers HIV care by promoting unproven cures, reliance on traditional healers, and misconceptions about injectable ART. Recognizing these sources and effects offers valuable insights for developing targeted communication strategies and policies that support correct health information and sustained HIV care for TGW.