SARS-COV-2 Infection and Testing Experiences in a Nationwide Sample of Transgender and Gender-Diverse Adults, June-December 2021

Citation

Wirtz, Andrea L.; Adams, Dee; Poteat, Tonia; Beckham, S. Wilson; Miller, Marissa; Brown, Carter; & Reisner, Sari L. (2023). SARS-COV-2 Infection and Testing Experiences in a Nationwide Sample of Transgender and Gender-Diverse Adults, June-December 2021. Public Health Reports, 138(2), 357-368. PMCID: PMC9790855

Abstract

OBJECTIVES: COVID-19 surveillance data are rarely collected or disaggregated by gender identity in the United States. We quantified COVID-19 testing experiences and SARS-CoV-2 infection history among transgender and gender-diverse (TGD) people to inform testing strategies and public health responses.
METHODS: From June 14 through December 16, 2021, TGD adults enrolled in a US nationwide online survey with optional SARS-CoV-2 antibody testing. We used multinomial regression analyses to identify correlates of suspected and confirmed SARS-CoV-2 infection (vs no known infection). We identified correlates of inability to access COVID-19 testing when needed using generalized linear models for binomial variables.
RESULTS: Participants (N = 2092) reported trans masculine (30.5%), trans feminine (27.3%), and nonbinary (42.2%) gender identities. Ten percent of respondents had a confirmed history of SARS-CoV-2 infection, and 29.8% had a history of suspected SARS-CoV-2 infection. Nonbinary gender (adjusted prevalence ratio [aPR] = 1.68; 95% CI, 1.12-2.53), experiencing homelessness (aPR = 1.65; 95% CI, 1.05-2.60), and food insecurity (aPR = 1.45; 95% CI, 1.03-2.04) were associated with confirmed SARS-CoV-2 infection. Food insecurity (aPR = 1.38; 95% CI, 1.10-1.72), chronic physical health condition (aPR = 1.44; 95% CI, 1.15-1.80), chronic mental health condition (aPR = 3.65; 95% CI, 2.40-5.56), and increased anticipated discrimination scores (aPR = 1.03; 95% CI, 1.01-1.05) were associated with suspected SARS-CoV-2 infection. Thirty-four percent (n = 694 of 2024) of participants reported an inability to access COVID-19 testing when needed, which was associated with Latinx or Hispanic ethnicity, inconsistent telephone access, homelessness, disability, and transportation limitations. The majority (79.4%) reported a complete COVID-19 vaccine course at the time of participation.
CONCLUSIONS: Inclusion of TGD people in public health surveillance and tailored public health strategies to address TGD communities' social and structural vulnerabilities may reduce barriers to COVID-19 testing.

URL

http://dx.doi.org/10.1177/00333549221138853

Reference Type

Journal Article

Year Published

2023

Journal Title

Public Health Reports

Author(s)

Wirtz, Andrea L.
Adams, Dee
Poteat, Tonia
Beckham, S. Wilson
Miller, Marissa
Brown, Carter
Reisner, Sari L.

Article Type

Regular

PMCID

PMC9790855

Data Set/Study

Leading Innovation for Transgender Women's Health and Empowerment (LITE) Study

Continent/Country

United States of America

State

Nonspecific

Sex/Gender

Gender Non-Binary
Transgender Men
Transgender Women

ORCiD

Poteat - 0000-0001-6541-3787