Groundbreaking Study Reveals Gender-Affirming Care Reduces HIV Risk Among Transgender and Gender-Diverse Communities

New Evidence on Gender-Affirming Care and HIV Outcomes

A recent landmark study led by the University of Michigan and published in The Lancet HIV offers encouraging news for transgender, nonbinary, and gender-diverse people: gender-affirming hormone therapy is associated with a 37% reduction in the risk of acquiring HIV and a 44% lower likelihood of having detectable HIV among those living with the virus. The study, which analyzed health records from over 8,000 patients at community health centers in Boston and New York City between 2013 and 2019, is one of the largest to date to examine the impact of gender-affirming care on HIV outcomes in these populations [University of Michigan School of Public Health, https://sph.umich.edu/news/2025posts/hiv-risk-decreases-in-transgender-nonbinary-and-gender-diverse-individuals.html, 2025-03-28].

Lead author Sari Reisner, Associate Professor of Epidemiology at the University of Michigan, emphasized the urgent need for research in this area, citing that transgender people are approximately 13 times more likely to be HIV-positive than other adults of reproductive age, according to the World Health Organization. Reisner noted, “Trans communities have been hard-hit by the HIV epidemic… Research on the health-promoting effects of hormone therapy for trans people is robust for mental health outcomes, but less so for other outcomes, like HIV. We aimed to fill the gap with this study” [University of Michigan School of Public Health, https://sph.umich.edu/news/2025posts/hiv-risk-decreases-in-transgender-nonbinary-and-gender-diverse-individuals.html, 2025-03-28].

Barriers and Inequalities Remain

Despite these promising findings, transgender, nonbinary, and gender-diverse people continue to face significant barriers to accessing health care, including HIV prevention and treatment. The World Health Organization reports that transgender individuals experience lower rates of access to health services due to violence, legal barriers, stigma, discrimination, and socioeconomic marginalization [University of Michigan School of Public Health, https://sph.umich.edu/news/2025posts/hiv-risk-decreases-in-transgender-nonbinary-and-gender-diverse-individuals.html, 2025-03-28].

These health disparities are compounded by threats to essential funding and resources. In early 2025, multiple leading LGBTQ+ and HIV advocacy organizations condemned moves by the federal government to close a key CDC HIV prevention division and reported cuts to HIV and AIDS research grants, which are vital for ongoing progress in prevention, treatment, and community-based outreach [Fenway Health, https://fenwayhealth.org/leading-lgbtq-hiv-and-health-organizations-across-u-s-condemn-trump-administrations-move-to-close-cdc-hiv-prevention-division/, 2025-03-19][The 19th News, https://19thnews.org/2025/04/hiv-research-lgbtq-people-trump-cdc-cuts/, 2025-04-10]. Many community-based organizations serving people living with HIV have expressed concern that reduced funding will disproportionately impact the most vulnerable, including transgender and gender-diverse individuals [Whitman-Walker Health, https://www.whitman-walker.org/what-is-next-and-new-in-hiv-for-2025/, 2025].

Global Context: 2025 HIV/AIDS Targets and LGBTQ+ Inclusion

The findings of the University of Michigan study align with global efforts to reduce HIV infections and address the needs of marginalized communities. The UNAIDS 2025 targets, established through extensive consultation with stakeholders worldwide, emphasize removing societal and legal impediments to service delivery, integrating HIV services with other health and social supports, and centering the needs of people most at risk—including transgender, nonbinary, and gender-diverse communities. These interim targets are seen as crucial steps toward the broader 2030 Sustainable Development Goals for ending the HIV epidemic [UNAIDS, https://aidstargets2025.unaids.org, 2025].

By focusing on societal enablers and integrated service delivery, the 2025 targets aim to address the inequalities—such as stigma, discrimination, and lack of access—that fuel HIV transmission and hinder effective prevention and care, especially among LGBTQ+ populations [UNAIDS, https://aidstargets2025.unaids.org, 2025].

Community Response and Call to Action

LGBTQ+ advocates and health leaders are urging governments and donors to maintain and expand support for evidence-based interventions, including gender-affirming care, community-based testing, and prevention programs tailored to high-risk populations. They stress that cutting back on HIV prevention and research funding at this critical juncture could reverse hard-won gains and further marginalize communities already facing significant health disparities [Fenway Health, https://fenwayhealth.org/leading-lgbtq-hiv-and-health-organizations-across-u-s-condemn-trump-administrations-move-to-close-cdc-hiv-prevention-division/, 2025-03-19][The 19th News, https://19thnews.org/2025/04/hiv-research-lgbtq-people-trump-cdc-cuts/, 2025-04-10].

As evidence grows for the effectiveness of gender-affirming care in improving HIV-related outcomes, the LGBTQ+ community and its allies are calling for policies that recognize the interconnectedness of health, rights, and social inclusion. Sustaining and expanding access to comprehensive, affirming health services remains a top priority in the fight to end HIV/AIDS—now more than ever.