Incidence of human immunodeficiency virus among male-to-female transgendered persons in San Francisco

Objective: To estimate HIV incidence among male-to-female transgendered per sons (MtF transgendered persons) who repeatedly tested for HIV antibodies a t Public San Francisco counseling and testing sites between July 1997 and J une 2000. Methods: HIV seroconversions were identified and person-time of observation were estimated using the date and result of the current test and the self- reported date and result of the previous test. Factors independently associ ated with HIV seroconversion were determined using multivariable proportion al hazard analysis. Results: HIV incidence was 7.8 per 100 person-years (95% confidence interva ls [CI], 4.6-12.3) based on 13 seroconversions among 155 repeat testers wit h 167.7 person-years of observation. African-American race/ethnicity (adjus ted relative hazard ratio [HR], 5.0; 95% CI, 1.5-16.2) and unprotected rece ptive anal intercourse MR, 3.9 95% CI, 1.2-13.1) were independent predictor s of HIV seroconversion. Conclusions: HIV is currently spreading at an extremely high rate among MtF transgendered persons in San Francisco, especially those Who are African A mericans.