The HIV hormone bridge: connecting impoverished HIV+ transsexual sex workers to HIV medical care. NLM AIDSLINE Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

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The HIV hormone bridge: connecting impoverished HIV+ transsexual sex workers to HIV medical care.

Unique Identifier : AIDSLINE ICA12/98406957
Grimaldi J; Jacobs J

Abstract: ISSUES: Male-to-female pre-operative transsexuals on illicitly obtained hormones treated at our HIV/AIDS clinic presented with poor records of medical compliance, health, substance abuse, sharing needles, and unsafe sex. PROJECT: Our clinic developed a specialized Transgender HIV program: a Transgender support group; staff education; integration of hormone therapy into HIV treatment, observation of hormones on HIV illness. RESULTS: We followed transgender patients over 4 years who joined a support group and turned away from exploitative "black market" hormone suppliers on condition that we prescribe and administer their hormones. HIV doctors received endocrinilogical instruction. Patients signed a treatment contract. Nurses administered hormone needles. Social work provided psycho-therapeutic & socio-economic counseling and managed HIV & hormone medication compliance. We placed HIV+ patients on hormones for a total of 18 patient years of follow-up and observed no side effects. It was not possible to assess the impact of hormone therapy on viral load or CD4 counts in this retrospective study given confounding variables. Integrating hormone treatments into HIV care did yield positive psycho-social results. All patients turned away from black market hormones, stopped sharing hormone needles and self-administering dangerous doses of hormones. Patients developed trust, became more compliant with HIV medication & condom use and more receptive to protease inhibitors. Prescribing hormones made them re-imbursable through medical insurance, thereby decreasing patients' financial need to sex work, violence from customers and police. Therapists engaged patients in non-judgmental discussion
981230
M98C1575

Copyright © 1998 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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