Neuropsychological, immunovirological, and socioeconomic profile of transgender women living with HIV: a retrospective cross-sectional study from an Italian reference center.
8 affiliations
- 1Department of Infectious Disease, Luigi Sacco Hospital, Regional Center for Infectious Diseases (CEREMI), Lombardy Region, Milan, Italy.
- 2Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
- 3Centre for Studies and Research in Cognitive Neuroscience, University of Bologna, Cesena, Italy.
- 4Department of Psychology, University of Bologna, Bologna, Italy.
- 5National PhD Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
- 6Institute of Health, School of Health Sciences, HES-SO Valais-Wallis, Sion, Switzerland.
- 7The Sense Innovation & Research Center, Lausanne, Switzerland.
- 8Centre for Multidisciplinary Action in Global Health (MAGH), University of Milan, Milan, Italy.
Abstract
Transgender women experience a disproportionate burden of HIV infection and intersecting social vulnerabilities. While virological outcomes among those retained in care are increasingly documented, data integrating neuropsychological health and socioeconomic determinants, particularly in European settings, remain scarce. Suboptimal cognitive performance may persist despite viral suppression, potentially undermining quality of life and long-term engagement in care.We aim to provide an integrated characterization of the immunovirological, neuropsychological, and socioeconomic profile of TW living with HIV attending a tertiary HIV reference center. We conducted a retrospective cross-sectional study at the outpatient HIV clinic of Luigi Sacco University Hospital, Milan, between 2011 and 2023. We included adult TW living with HIV who had adequate proficiency in Italian and had undergone standardized neuropsychological assessment. Clinical, immunovirological, neuropsychological, and socioeconomic data were extracted from medical records and analyzed descriptively. Ninety-five participants were included, predominantly Latin American migrants (95.8%) engaged in sex work (95.6%), with high rates of regular substance use (69.5%). Most participants were virologically suppressed at the time of neuropsychological assessment (78.5%), and nearly all had CD4 counts above 200 cells/µL (97.9%). Nonetheless, performances below normative thresholds were frequently observed, particularly on tests assessing processing speed and sustained attention (45.3%) and immediate verbal memory (60.0%). Sixty percent of participants (51/85) self-reported at least one complaint across memory, attention, and mental speed domains. Among participants with below-threshold performances immunovirological characteristics appeared broadly comparable to those with preserved performances across all tests, whereas benzodiazepine use was numerically more prevalent on 6 out of 8 measures, followed by regular substance use to a lesser extent. Educational attainment showed no consistent direction across tests. In this clinic-based population of TW living with HIV, performances below normative thresholds across several neuropsychological measures and marked socioeconomic vulnerability were frequently observed despite generally favorable virological outcomes. These findings support the integration of neuropsychological evaluation, substance use assessment, and gender-affirming services into comprehensive, multidisciplinary HIV care models for this population.
Related
- Spectrum and immunovirological determinants of tumours among people living with HIV in Uganda: A retrospective cross sectional study from a specialised HIV centre, 2017–2026
- Smartphone addiction screening status and associated physical and neuropsychological symptoms among Syrian university students: a cross-sectional study.
- Prevalence of physical inactivity and associated factors among transgender people: a cross-sectional study, Baixada Santista, Brazil, 2023.
- Past-year violence experienced by transgender women living with HIV with or without recent involvement in transactional sex: the French national cross-sectional ANRS-Trans&HIV study
- Family socioeconomic status and attention-deficit/hyperactivity disorder symptoms in preschool children: a cross-sectional study of 21,366 parent–child dyads in Yan’an, western China
BibTeX
@article{scaglione2026neuropsychological,
title = {{Neuropsychological, immunovirological, and socioeconomic profile of transgender women living with HIV: a retrospective cross-sectional study from an Italian reference center.}},
author = {Giovanni Scaglione and Federico Fama and Loredana Catinari and Claudia Conflitti and Stefania Caronni and Gaia Risso and Maria Vittoria Cossu and Marta Colaneri and Andrea Gori and Chiara Atzori},
journal = {Frontiers in reproductive health},
year = {2026},
month = oct,
doi = {10.3389/frph.2026.1920771},
url = {https://europepmc.org/article/MED/42952739},
note = {CC BY},
}
RIS
TY - JOUR
TI - Neuropsychological, immunovirological, and socioeconomic profile of transgender women living with HIV: a retrospective cross-sectional study from an Italian reference center.
AU - Giovanni Scaglione
AU - Federico Fama
AU - Loredana Catinari
AU - Claudia Conflitti
AU - Stefania Caronni
AU - Gaia Risso
AU - Maria Vittoria Cossu
AU - Marta Colaneri
AU - Andrea Gori
AU - Chiara Atzori
PY - 2026
DA - 2026/10/14
JO - Frontiers in reproductive health
DO - 10.3389/frph.2026.1920771
UR - https://europepmc.org/article/MED/42952739
AB - Transgender women experience a disproportionate burden of HIV infection and intersecting social vulnerabilities. While virological outcomes among those retained in care are increasingly documented, data integrating neuropsychological health and socioeconomic determinants, particularly in European settings, remain scarce. Suboptimal cognitive performance may persist despite viral suppression, potentially undermining quality of life and long-term engagement in care.We aim to provide an integrated characterization of the immunovirological, neuropsychological, and socioeconomic profile of TW living with HIV attending a tertiary HIV reference center. We conducted a retrospective cross-sectional study at the outpatient HIV clinic of Luigi Sacco University Hospital, Milan, between 2011 and 2023. We included adult TW living with HIV who had adequate proficiency in Italian and had undergone standardized neuropsychological assessment. Clinical, immunovirological, neuropsychological, and socioeconomic data were extracted from medical records and analyzed descriptively. Ninety-five participants were included, predominantly Latin American migrants (95.8%) engaged in sex work (95.6%), with high rates of regular substance use (69.5%). Most participants were virologically suppressed at the time of neuropsychological assessment (78.5%), and nearly all had CD4 counts above 200 cells/µL (97.9%). Nonetheless, performances below normative thresholds were frequently observed, particularly on tests assessing processing speed and sustained attention (45.3%) and immediate verbal memory (60.0%). Sixty percent of participants (51/85) self-reported at least one complaint across memory, attention, and mental speed domains. Among participants with below-threshold performances immunovirological characteristics appeared broadly comparable to those with preserved performances across all tests, whereas benzodiazepine use was numerically more prevalent on 6 out of 8 measures, followed by regular substance use to a lesser extent. Educational attainment showed no consistent direction across tests. In this clinic-based population of TW living with HIV, performances below normative thresholds across several neuropsychological measures and marked socioeconomic vulnerability were frequently observed despite generally favorable virological outcomes. These findings support the integration of neuropsychological evaluation, substance use assessment, and gender-affirming services into comprehensive, multidisciplinary HIV care models for this population.
SN - 2673-3153
ER -