Transgender health in Australia: HIV drops by 94% as PrEP increases over 10 years

A ten year retrospective database study in Australia reported a 94% drop in HIV incidence among over 7,000 transgender and non-binary people using sexual health services, as PrEP use also significantly increased.

This study also showed the importance of collecting accurate data to support transgender health.

The primary analysis included >7200 people in the transgender group (4672 transgender women, 2213 transgender men and 399 non-binary people). Results were compared to two control groups: (i) >152,000 cisgender gay and bisexual men and (ii) >393,000 cisgender heterosexuals.

Most baseline characteristics were similar in all three groups although fewer people in the trans group were born overseas (41% vs 47% vs 58%), respectively.

HIV positive rates were higher though (3.0% vs 2.4% vs 0.2%), as were rates of recent sex work (19% vs 1.8% vs 6.9%), respectively.

Overall HIV incidence per 100 years of follow-up was 0.33 (n=79 cases) vs 0.29 and 0.003 in the transgender vs cisgender GBMSM and heterosexual groups respectively. Data was also reported for other STIs which were significantly higher in the transgender group compared to gay men and were significantly lower in heterosexuals.

However, HIV rates decreased by 94% over ten years amongst transgender people, even after controlling for changes in sex work and partner numbers. PrEP uptake also increased among the transgender group from 18% in 2016 to 30% in 2023.

Although there were limitations in this study, including in the datasets available, the researchers concluded that it would be important to build on their successful results by making sure that HIV and STI policies, guidelines, interventions and funding in Australia more actively support transgender populations.

Reference
Callander D et al. Trends in incidence of HIV and other sexually transmissible infections among transgender people in Australia: a retrospective 10-year national clinical cohort study. Lancet HIV, open access. (27 April 2026).
https://doi.org/10.1016/S2352-3018(26)00010-X