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Cardiovascular Disease Risk Among Transgender People with HIV

  • Complications of HIV and Antiretroviral Therapy (GA McComsey, Section Editor)
  • Published:
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Abstract

Purpose of Review

Transgender individuals are at disproportionate risk for HIV infection, with prevalence rates highest among transgender women of color. Antiretroviral therapy (ART)-treated people with HIV (PWH) are at increased risk for cardiovascular disease (CVD), in relation to persistent systemic immune activation and metabolic dysregulation. The purpose of this review is to examine parameters which may affect CVD risk among transgender PWH.

Recent Findings

Among transgender women and men, prospective longitudinal studies have shown that gender-affirming hormonal therapy (GAHT) is associated with select deleterious cardiometabolic effects such as increases in visceral adipose tissue. Retrospective studies among transgender women and men suggest an increase in CVD risk, such as venous thromboembolism, cerebrovascular accidents, and myocardial infarction. Studies among transgender PWH adhering to GAHT and ART suggest heightened systemic immune activation/inflammation.

Summary

Prospective longitudinal studies assessing factors associated with increased CVD events among transgender PWH are needed to guide the development of CVD prevention strategies in this at-risk population.

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Availability of Data and Material

All data presented are from published manuscripts and/or abstracts.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Becasen JS, Denard CL, Mullins MM, Higa DH, Sipe TA. Estimating the prevalence of HIV and sexual behaviors among the US transgender population: a systematic review and meta-analysis, 2006–2017. Am J Public Health. 2019;109(1):e1–8.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Centers for Disease Control and Prevention. Core indicators for monitoring the Ending the HIV Epidemic initiative : HIV diagnoses and linkage to HIV medical care, 2019 and 2020 (preliminary data reported through June 2020). HIV Surveillance Data Tables 2020;1(No. 6) http://www.cdc.gov/hiv/library/reports/surveillance-data-tables/vol-1-no-6/index.html. Published October 2020. Accessed [November 2020].

  3. Prevention. CfDCa. Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2014–2018. 2020 [Available from: http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. November 2020

  4. Baral SD, Poteat T, Stromdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13(3):214–22.

    Article  PubMed  Google Scholar 

  5. Poteat T, Reisner SL, Radix A. HIV epidemics among transgender women. Curr Opin HIV AIDS. 2014;9(2):168–73.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Triant VA, Lee H, Hadigan C, Grinspoon SK. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab. 2007;92(7):2506–12.

    Article  CAS  PubMed  Google Scholar 

  7. Freiberg MS, Chang CC, Kuller LH, Skanderson M, Lowy E, Kraemer KL, et al. HIV infection and the risk of acute myocardial infarction. JAMA Intern Med. 2013;173(8):614–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Freiberg MS, Chang CH, Skanderson M, Patterson OV, DuVall SL, Brandt CA, et al. Association between HIV infection and the risk of heart failure with reduced ejection fraction and preserved ejection fraction in the antiretroviral therapy era: results from the Veterans Aging Cohort Study. JAMA Cardiol. 2017;2(5):536–46.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Butt AA, Chang CC, Kuller L, Goetz MB, Leaf D, Rimland D, et al. Risk of heart failure with human immunodeficiency virus in the absence of prior diagnosis of coronary heart disease. Arch Intern Med. 2011;171(8):737–43.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Feinstein MJ, Steverson AB, Ning H, Pawlowski AE, Schneider D, Ahmad FS, et al. Adjudicated heart failure in HIV-infected and uninfected men and women. J Am Heart Assoc. 2018;7(21):e009985.

  11. Janjua SA, Triant VA, Addison D, Szilveszter B, Regan S, Staziaki PV, et al. HIV infection and heart failure outcomes in women. J Am Coll Cardiol. 2017;69(1):107–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Tseng ZH, Secemsky EA, Dowdy D, Vittinghoff E, Moyers B, Wong JK, et al. Sudden cardiac death in patients with human immunodeficiency virus infection. J Am Coll Cardiol. 2012;59(21):1891–6.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Yen YF, Lai YJ, Chen YY, Lai HH, Chuang PH, Chen CC, et al. Association of HIV infection and antiretroviral therapy with sudden cardiac death. J Acquir Immune Defic Syndr. 2019;82(5):468–74.

    Article  PubMed  Google Scholar 

  14. Ahonkhai AA, Gebo KA, Streiff MB, Moore RD, Segal JB. Venous thromboembolism in patients with HIV/AIDS: a case-control study. J Acquir Immune Defic Syndr. 2008;48(3):310–4.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Durand M, Sinyavskaya L, Jin YL, Tremblay CL, Ducruet T, Laskine M. Incidence of venous thromboembolism in patients living with HIV: a cohort study. AIDS Patient Care STDS. 2019;33(11):455–8.

    Article  PubMed  Google Scholar 

  16. Copur AS, Smith PR, Gomez V, Bergman M, Homel P. HIV infection is a risk factor for venous thromboembolism. AIDS Patient Care STDS. 2002;16(5):205–9.

    Article  PubMed  Google Scholar 

  17. Rasmussen LD, Dybdal M, Gerstoft J, Kronborg G, Larsen CS, Pedersen C, et al. HIV and risk of venous thromboembolism: a Danish nationwide population-based cohort study. HIV Med. 2011;12(4):202–10.

    Article  CAS  PubMed  Google Scholar 

  18. Frazier EL, Sutton MY, Brooks JT, Shouse RL, Weiser J. Trends in cigarette smoking among adults with HIV compared with the general adult population, United States - 2009–2014. Prev Med. 2018;111:231–4.

    Article  PubMed  Google Scholar 

  19. Bakal DR, Coelho LE, Luz PM, Clark JL, De Boni RB, Cardoso SW, et al. Obesity following ART initiation is common and influenced by both traditional and HIV-/ART-specific risk factors. J Antimicrob Chemother. 2018;73(8):2177–85.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Stanley TL, Grinspoon SK. Body composition and metabolic changes in HIV-infected patients. J Infect Dis. 2012;205(Suppl 3):S383–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Bogorodskaya M, Fitch KV, Lu M, Torriani M, Zanni MV, Looby SE, et al. Measures of adipose tissue redistribution and atherosclerotic coronary plaque in HIV. Obesity (Silver Spring). 2020;28(4):749–55.

    Article  CAS  Google Scholar 

  22. Srinivasa S, Fitch KV, Torriani M, Zanni MV, Defilippi C, Christenson R, et al. Relationship of visceral and subcutaneous adipose depots to markers of arterial injury and inflammation among individuals with HIV. AIDS. 2019;33(2):229–36.

    Article  PubMed  Google Scholar 

  23. Sandler NG, Wand H, Roque A, Law M, Nason MC, Nixon DE, et al. Plasma levels of soluble CD14 independently predict mortality in HIV infection. J Infect Dis. 2011;203(6):780–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Burdo TH, Lo J, Abbara S, Wei J, DeLelys ME, Preffer F, et al. Soluble CD163, a novel marker of activated macrophages, is elevated and associated with noncalcified coronary plaque in HIV-infected patients. J Infect Dis. 2011;204(8):1227–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Funderburg NT, Mayne E, Sieg SF, Asaad R, Jiang W, Kalinowska M, et al. Increased tissue factor expression on circulating monocytes in chronic HIV infection: relationship to in vivo coagulation and immune activation. Blood. 2010;115(2):161–7.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Mayne E, Funderburg NT, Sieg SF, Asaad R, Kalinowska M, Rodriguez B, et al. Increased platelet and microparticle activation in HIV infection: upregulation of P-selectin and tissue factor expression. J Acquir Immune Defic Syndr. 2012;59(4):340–6.

  27. O’Brien M, Montenont E, Hu L, Nardi MA, Valdes V, Merolla M, et al. Aspirin attenuates platelet activation and immune activation in HIV-1-infected subjects on antiretroviral therapy: a pilot study. J Acquir Immune Defic Syndr. 2013;63(3):280–8.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Schechter ME, Andrade BB, He T, Richter GH, Tosh KW, Policicchio BB, et al. Inflammatory monocytes expressing tissue factor drive SIV and HIV coagulopathy. Sci Transl Med. 2017;9(405).

  29. Zanni MV, Toribio M, Robbins GK, Burdo TH, Lu MT, Ishai AE, et al. Effects of antiretroviral therapy on immune function and arterial inflammation in treatment-naive patients with human immunodeficiency virus infection. JAMA Cardiol. 2016;1(4):474–80.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Buchting FO, Emory KT, Scout, Kim Y, Fagan P, Vera LE, et al. Transgender use of cigarettes, cigars, and E-cigarettes in a national study. Am J Prev Med. 2017;53(1):e1-e7.

  31. Hughto JMW, Quinn EK, Dunbar MS, Rose AJ, Shireman TI, Jasuja GK. Prevalence and co-occurrence of alcohol, nicotine, and other substance use disorder diagnoses among US transgender and cisgender adults. JAMA Netw Open. 2021;4(2):e2036512.

  32. Santos GM, Rapues J, Wilson EC, Macias O, Packer T, Colfax G, et al. Alcohol and substance use among transgender women in San Francisco: prevalence and association with human immunodeficiency virus infection. Drug Alcohol Rev. 2014;33(3):287–95.

    Article  PubMed  Google Scholar 

  33. Jones BA, Haycraft E, Bouman WP, Arcelus J. The levels and predictors of physical activity engagement within the treatment-seeking transgender population: a matched control study. J Phys Act Health. 2018;15(2):99–107.

    Article  PubMed  Google Scholar 

  34. Braun HM, Candelario J, Hanlon CL, Segura ER, Clark JL, Currier JS, et al. Transgender women living with HIV frequently take antiretroviral therapy and/or feminizing hormone therapy differently than prescribed due to drug-drug interaction concerns. LGBT Health. 2017;4(5):371–5.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Hembree WC, Cohen-Kettenis PT, Gooren L, Hannema SE, Meyer WJ, Murad MH, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2017;102(11):3869–903.

    Article  PubMed  Google Scholar 

  36. Moore E, Wisniewski A, Dobs A. Endocrine treatment of transsexual people: a review of treatment regimens, outcomes, and adverse effects. J Clin Endocrinol Metab. 2003;88(8):3467–73.

    Article  CAS  PubMed  Google Scholar 

  37. Toorians AW, Thomassen MC, Zweegman S, Magdeleyns EJ, Tans G, Gooren LJ, et al. Venous thrombosis and changes of hemostatic variables during cross-sex hormone treatment in transsexual people. J Clin Endocrinol Metab. 2003;88(12):5723–9.

    Article  CAS  PubMed  Google Scholar 

  38. Asscheman H, Giltay EJ, Megens JA, de Ronde WP, van Trotsenburg MA, Gooren LJ. A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones. Eur J Endocrinol. 2011;164(4):635–42.

    Article  CAS  PubMed  Google Scholar 

  39. Elbers JM, Asscheman H, Seidell JC, Gooren LJ. Effects of sex steroid hormones on regional fat depots as assessed by magnetic resonance imaging in transsexuals. Am J Physiol. 1999;276(2 Pt 1):E317–25.

    CAS  PubMed  Google Scholar 

  40. Fighera TM, da Silva E, Lindenau JD, Spritzer PM. Impact of cross-sex hormone therapy on bone mineral density and body composition in transwomen. Clin Endocrinol (Oxf). 2018;88(6):856–62.

    Article  CAS  Google Scholar 

  41. Smith MR, Finkelstein JS, McGovern FJ, Zietman AL, Fallon MA, Schoenfeld DA, et al. Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab. 2002;87(2):599–603.

    Article  CAS  PubMed  Google Scholar 

  42. Smith MR, Saad F, Egerdie B, Sieber PR, Tammela TL, Ke C, et al. Sarcopenia during androgen-deprivation therapy for prostate cancer. J Clin Oncol. 2012;30(26):3271–6.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Elbers JM, Giltay EJ, Teerlink T, Scheffer PG, Asscheman H, Seidell JC, et al. Effects of sex steroids on components of the insulin resistance syndrome in transsexual subjects. Clin Endocrinol (Oxf). 2003;58(5):562–71.

    Article  CAS  Google Scholar 

  44. Deutsch MB, Bhakri V, Kubicek K. Effects of cross-sex hormone treatment on transgender women and men. Obstet Gynecol. 2015;125(3):605–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Auer MK, Ebert T, Pietzner M, Defreyne J, Fuss J, Stalla GK, et al. Effects of sex hormone treatment on the metabolic syndrome in transgender individuals: focus on metabolic cytokines. J Clin Endocrinol Metab. 2018;103(2):790–802.

    Article  PubMed  Google Scholar 

  46. • Getahun D, Nash R, Flanders WD, Baird TC, Becerra-Culqui TA, Cromwell L, et al. Cross-sex hormones and acute cardiovascular events in transgender persons: a cohort study. Ann Intern Med. 2018;169(4):205–13. This retrospective database study examined the incidence of cardiovascular disease events among transgender individuals on GAHT in the United States.

    Article  PubMed  PubMed Central  Google Scholar 

  47. • Alzahrani T, Nguyen T, Ryan A, Dwairy A, McCaffrey J, Yunus R, et al. Cardiovasculardisease risk factors and myocardial infarction in the transgender population. Circ Cardiovasc Qual Outcomes. 2019;12(4):e005597. This retrospective database study examined the rate of cardiovascular disease risk factors and myocardial infarction among transgender individuals compared to the general population.

  48. • Nota NM, Wiepjes CM, de Blok CJM, Gooren LJG, Kreukels BPC, den Heijer M. Occurrence of acute cardiovascular events in transgender individuals receiving hormone therapy. Circulation. 2019;139(11):1461–2. This retrospective database study examined the incidence of cardiovascular disease events among transgender individuals on GAHT in the Netherlands.

    Article  PubMed  Google Scholar 

  49. van Velzen DM, Paldino A, Klaver M, Nota NM, Defreyne J, Hovingh GK, et al. Cardiometabolic effects of testosterone in transmen and estrogen plus cyproterone acetate in transwomen. J Clin Endocrinol Metab. 2019;104(6):1937–47.

    Article  PubMed  Google Scholar 

  50. • Caceres BA, Jackman KB, Edmondson D, Bockting WO. Assessing gender identity differences in cardiovascular disease in US adults: an analysis of data from the 2014–2017 BRFSS. J Behav Med. 2020;43(2):329–38. This survey-based study examined the incidence of cardiovascular disease reported by transgender individuals.

    Article  PubMed  Google Scholar 

  51. •• Gogia S, Coromilas A, Regan S, Stone L, Fourman LT, Triant VA, et al. Cardiovascular risk profile of transgender women with HIV: a US health care database study. J Acquir Immune Defic Syndr. 2018;79(1):e39–41. This retrospective database study investigated the incidence of CVD risk factor profiles among transgender WWH compared to cisgender MWH.

    Article  PubMed  PubMed Central  Google Scholar 

  52. •• Gosiker BJ, Lesko CR, Rich AJ, Crane HM, Kitahata MM, Reisner SL, et al. Cardiovascular disease risk among transgender women living with HIV in the United States. PLoS One. 2020;15(7):e0236177. This retrospective cohort database study examined the prevalence of elevated CVD risk scores among transgender WWH compared to cisgender MWH and cisgender WWH, respectively.

  53. Cottrell ML, Prince HMA, Schauer AP, Sykes C, Maffuid K, Poliseno A, et al. Decreased tenofovir diphosphate concentrations in a transgender female cohort: implications for human immunodeficiency virus preexposure prophylaxis. Clin Infect Dis. 2019;69(12):2201–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Hiransuthikul A, Janamnuaysook R, Himmad K, Kerr SJ, Thammajaruk N, Pankam T, et al. Drug-drug interactions between feminizing hormone therapy and pre-exposure prophylaxis among transgender women: the iFACT study. J Int AIDS Soc. 2019;22(7):e25338.

  55. Shieh E, Marzinke MA, Fuchs EJ, Hamlin A, Bakshi R, Aung W, et al. Transgender women on oral HIV pre-exposure prophylaxis have significantly lower tenofovir and emtricitabine concentrations when also taking oestrogen when compared to cisgender men. J Int AIDS Soc. 2019;22(11):e25405.

  56. Grant RM, Pellegrini M, Defechereux PA, Anderson PL, Yu M, Glidden DV, et al. Sex hormone therapy and tenofovir diphosphate concentration in dried blood spots: primary results of the iBrEATHe study. Clin Infect Dis. 2020.

  57. Hiransuthikul A, Himmad L, Kerr SJ, Janamnuaysook R, Dalodom T, Phanjaroen K, et al. Drug-drug interactions among Thai HIV-positive transgender women undergoing feminizing hormone therapy and antiretroviral therapy: the iFACT study. Clin Infect Dis. 2020.

  58. Wiegratz I, Jung-Hoffmann C, Gross W, Kuhl H. Effect of two oral contraceptives containing ethinyl estradiol and gestodene or norgestimate on different lipid and lipoprotein parameters. Contraception. 1998;58(2):83–91.

    Article  CAS  PubMed  Google Scholar 

  59. Campagnoli C, Belforte P, Di Sario MM, Lesca L. Lipid profile during hormone replacement therapy: effect of different progestins? Zentralbl Gynakol. 1997;119(Suppl 2):1–6.

    CAS  PubMed  Google Scholar 

  60. Gokmen O, Yapar Eyi EG. Hormone replacement therapy and lipid-lipoprotein concentrations. Eur J Obstet Gynecol Reprod Biol. 1999;85(1):31–41.

    Article  CAS  PubMed  Google Scholar 

  61. Elbers JM, Asscheman H, Seidell JC, Megens JA, Gooren LJ. Long-term testosterone administration increases visceral fat in female to male transsexuals. J Clin Endocrinol Metab. 1997;82(7):2044–7.

    CAS  PubMed  Google Scholar 

  62. Munzer T, Harman SM, Hees P, Shapiro E, Christmas C, Bellantoni MF, et al. Effects of GH and/or sex steroid administration on abdominal subcutaneous and visceral fat in healthy aged women and men. J Clin Endocrinol Metab. 2001;86(8):3604–10.

    Article  CAS  PubMed  Google Scholar 

  63. Herbst KL, Bhasin S. Testosterone action on skeletal muscle. Curr Opin Clin Nutr Metab Care. 2004;7(3):271–7.

    Article  CAS  PubMed  Google Scholar 

  64. Ohlander SJ, Varghese B, Pastuszak AW. Erythrocytosis following testosterone therapy. Sex Med Rev. 2018;6(1):77–85.

    Article  PubMed  Google Scholar 

  65. Walecki M, Eisel F, Klug J, Baal N, Paradowska-Dogan A, Wahle E, et al. Androgen receptor modulates Foxp3 expression in CD4+CD25+Foxp3+ regulatory T-cells. Mol Biol Cell. 2015;26(15):2845–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Albany CJ, Trevelin SC, Giganti G, Lombardi G, Scotta C. Getting to the heart of the matter: the role of regulatory T-cells (Tregs) in cardiovascular disease (CVD) and atherosclerosis. Front Immunol. 2019;10:2795.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Longenecker CT, Sullivan C, Baker JV. Immune activation and cardiovascular disease in chronic HIV infection. Curr Opin HIV AIDS. 2016;11(2):216–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Kaiafa G, Kanellos I, Savopoulos C, Kakaletsis N, Giannakoulas G, Hatzitolios AI. Is anemia a new cardiovascular risk factor? Int J Cardiol. 2015;186:117–24.

    Article  PubMed  Google Scholar 

  69. O’Brien ME, Kupka R, Msamanga GI, Saathoff E, Hunter DJ, Fawzi WW. Anemia is an independent predictor of mortality and immunologic progression of disease among women with HIV in Tanzania. J Acquir Immune Defic Syndr. 2005;40(2):219–25.

    Article  PubMed  Google Scholar 

  70. •• Lake J, Wang R, Barett B, Funderburg N, Bowman E, Debroy P, et al., editors. Hormone use and HIV alter cardiovascular biomarker profile in transgender women. Conference on Retroviruses and Opportunistic Infection 2020; Boston, MA. This study compared systemic levels of markers of immune activation associated with CVD among transgender WWH versus cisgender MWH.

  71. •• Lake J, Miao H, Kettelhut2 A, Clark J, Lama JR, Reisner S, et al., editors. Feminizingtherapy decreases D-dimer but worsens insulin sensitivity in trans women. CROI 2021; Boston, MA (Virtual Meeting). This study examined the effect of feminizing hormone therapy on d-dimer levels and insulin sensitivity among transgender women with and without HIV.

  72. Robinson JA, Jamshidi R, Burke AE. Contraception for the HIV-positive woman: a review of interactions between hormonal contraception and antiretroviral therapy. Infect Dis Obstet Gynecol. 2012;2012:890160.

  73. Radix A, Sevelius J, Deutsch MB. Transgender women, hormonal therapy and HIV treatment: a comprehensive review of the literature and recommendations for best practices. J Int AIDS Soc. 2016;19(3 Suppl 2):20810.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Deutsch MB, Glidden DV, Sevelius J, Keatley J, McMahan V, Guanira J, et al. HIV pre-exposure prophylaxis in transgender women: a subgroup analysis of the iPrEx trial. Lancet HIV. 2015;2(12):e512–9.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Grinspoon SK, Douglas PS, Hoffmann U, Ribaudo HJ. Leveraging a landmark trial of primary cardiovascular disease prevention in human immunodeficiency virus: introduction from the REPRIEVE coprincipal investigators. J Infect Dis. 2020;222(Supplement_1):S1-S7.

  76. Smeaton LM, Kileel EM, Grinsztejn B, Gardner EM, Starr K, Murry ML, et al. Characteristics of REPRIEVE trial participants identifying across the transgender spectrum. J Infect Dis. 2020;222(Supplement_1):S31-S40.

  77. Toribio M. Effects of gender-affirming hormone therapy among transgender women. Massachusetts General Hospital: NIH; 2019.

  78. Lake JEF, Nicholas T. Comprehensive HIV+/- Analysis of iNflammation in transGender women on Estrogen Supplementation: the CHANGES study. NIH: University of Texas Health Science Center Houston, Houston, TX, United States; 2018.

    Google Scholar 

  79. Rich AJ, Williams J, Malik M, Wirtz A, Reisner S, DuBois LZ, et al. Biopsychosocial mechanisms linking gender minority stress to HIV comorbidities Among Black and Latina transgender women (LITE Plus): protocol for a mixed methods longitudinal study. JMIR Res Protoc. 2020;9(4):e17076.

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Funding

MT is supported by the NIH/ National Heart, Lung, and Blood Institute (NHLBI) grant (1K23HL147799-01.) and American Heart Association-Harold Amos Medical Faculty Development Program through the Robert Wood Johnson Foundation. This work was also supported by the Nutrition Obesity Research Center at Harvard (DK040561) and by grants to the Harvard Clinical and Translational Science Center from the National Center for Research Resources (8 UL 1TR000170 and 1 UL 1TR001102).

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Author notes

  1. Markella V Zanni and Mabel Toribio are co-senior authors and contributed equally.

Authors and Affiliations

  1. Metabolism Unit, Division of Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Madeline Cetlin, Evelynne S. Fulda, Sarah M. Chu, Markella V. Zanni & Mabel Toribio

  2. Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Ole-Petter R. Hamnvik

  3. Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA

    Tonia Poteat

  4. Metabolism Unit, Division of Endocrinology, Massachusetts General Hospital, 55 Fruit Street, 5 LON 207, Boston, MA, 02114, USA

    Markella V. Zanni & Mabel Toribio

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  1. Madeline Cetlin
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Correspondence to Markella V. Zanni or Mabel Toribio.

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MT, MC, ESF, SMC, and OPRH have no disclosures to report. TP is a Principal Investigator of an Industry-Initiated Research Grant from Viiv Healthcare to her institution, unrelated to the present project. MVZ is a Principal Investigator of an Investigator-Initiated Research Grant from Gilead to her institution, unrelated to the present project.

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Cetlin, M., Fulda, E.S., Chu, S.M. et al. Cardiovascular Disease Risk Among Transgender People with HIV. Curr HIV/AIDS Rep 18, 407–423 (2021). https://doi.org/10.1007/s11904-021-00572-z

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