Epidemiology of chronic disease and multimorbidity for transgender people living with and without HIV
department or school: Medicine, Faculty of
department or school: Population and Public Health (SPPH), School of
data provider: DSpace
degree campus: UBCV
creator: Rich, Ashleigh
issued: 2021-03-10T18:26:09Z
issued: 2021
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: Introduction: Given limited evidence of the epidemiology of chronic disease and multimorbidity for transgender people living with and without HIV, the purpose of this dissertation was to: 1) systematically review chronic disease burden for transgender populations globally; 2) assess methods for identifying transgender people with and without HIV in administrative data, to facilitate investigation of chronic disease-related and other healthcare utilization for this population; and 3) investigate multimorbidity burden for transgender compared to cisgender people living with HIV. Methods: Systematic review methods were used to review and narratively synthesize the empirical literature on chronic disease among transgender populations, globally. Healthcare records were used to develop and validate a computable phenotype to identity transgender people in a large linked provincial administrative dataset. Longitudinal analysis methods were used to examine multimorbidity prevalence and incidence for transgender compared to cisgender people in North America in a large longitudinal HIV cohort collaborative. Key Findings: The literature on chronic disease among transgender populations is focused on mental and sexual health, with sparse attention to chronic physical health, in particular age-related chronic conditions and inflammation-related disease. Identification of transgender people is feasible in administrative health data, with high specificity, concordance with transgender-specific healthcare utilization, and ability to reliably characterize transgender populations in terms of demographics and chronic disease. Transgender people living with HIV had elevated incidence and prevalence of multimorbidity compared to cisgender people living with HIV, though inconsistently over time and without strong evidence of statistically significant differences by gender identity. Conclusions: High quality evidence of chronic conditions among transgender populations is needed; in particul…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/77503
note: EPIDEMIOLOGY OF CHRONIC DISEASE AND MULTIMORBIDITY FOR TRANSGENDER PEOPLE LIVING WITH AND WITHOUT HIV by Ashleigh Rich MPH, The University of British Columbia, 2013 B.A., Smith College, 2008 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Population and Public Health) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) March 2021 © Ashleigh Rich, 2021 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: The epidemiology of chronic disease and multimorbidity for transgender people living with and without HIV submitted by Ashleigh Rich in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Population & Public Health Examining Committee: Mieke Koehoorn, Interim Director and Professor, School of Population & Public Health, UBC Co-supervisor Robert Hogg, Professor, Faculty of Health Sciences, Simon Fraser University Co-supervisor Tonia Poteat, Assistant Professor, Deptartment of Social Medicine, University of North Carolina- Chapel Hill Supervisory Committee Member Joel Singer, Professor, School of Population & Public Health, UBC & University Examiner Dr. Elizabeth Saewyc, Director and Professor, School of Nursing, UBC University Examiner iii Abstract Introduction: Given limited evidence of the epidemiology of chronic disease and multimorbidity for transgender people living with and without HIV, the purpose of this dissertation was to: 1) systematically review chronic disease burden for transgender populations globally; 2) assess methods for identifying transgender people with and without HIV in administrative data, to facilitate investigation of chronic disease-related and other healthcare utilization for this population; and 3) investigate multimorbidity burden for transgender compared to cisgender people living with HIV. Method…
has type: Thesis/Dissertation
date issued: 2021-05
is shown at: 10.14288/1.0396096
language: eng
degree discipline: Population and Public Health
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
type: Text
identifier URI: http://hdl.handle.net/2429/77503