# Cardiometabolic Effects of Gender-Affirming Hormonal Therapy among Transgender Women with HIV

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $198,391

## Abstract

PROJECT SUMMARY/ ABSTRACT
Around one third of transgender individuals in the United States are living with HIV. People with HIV on anti-
retroviral therapy face an increased risk of cardiometabolic disease, even after controlling for traditional risk
factors. Gender-affirming hormone therapy, in turn, may adversely affect the metabolic health of transgender
women by increasing visceral adipose tissue and may also increase the risk of myocardial infarctions and
venous thromboembolism. The increased risk for cardiometabolic disease among PWH together with the
known effects of gender-affirming hormone therapy among non-HIV-infected transgender women underscores
the significance of the aims of this proposal.
The central hypothesis for this proposal is that gender-affirming hormone therapy in transgender WHIV will
have both beneficial and adverse cardiometabolic effects, reflecting complex downstream consequences of
concomitant testosterone suppression and estrogen replacement. The candidate will apply a highly innovative
approach to, for the first time, prospectively investigate the effect of testosterone suppression and estrogen
therapy on: aim 1 - body composition, ectopic fat deposition, insulin sensitivity, and lipid levels, aim 2 –
myocardial structure and function; aim 3 – coagulation parameters (including coagulation factors and tissue
factor expression on monocytes). This proposal will provide critically needed information regarding the safety
of gender-affirming therapy in this population and identify possible targets for adjunctive therapies to hormone
therapy which may optimize the cardiometabolic health of transgender WHIV.
The candidate is an outstanding clinical investigator who is dedicated to developing her own research track
centered on the cardiometabolic health of transgender individuals living with HIV. In the short term, she hopes
to obtain the necessary skills to independently pursue patient-oriented physiology research in the field of
transgender medicine in HIV and the preliminary data for an RO1 proposal. In the long term, she plans to
utilize these skills and preliminary data to become an R01-funded clinical investigator. This proposal will be
supported by an excellent team of mentors and collaborators who will provide complementary expertise in
the areas of HIV-associated cardiometabolic disease, Cardiology, Infectious Disease, Immunology and
Biostatistics. The institutional environment of Massachusetts General Hospital (MGH) and Harvard-affiliated
institutions will provide the candidate excellent resources and opportunities for successful completion of the
proposed study and her career development plan.
.

## Key facts

- **NIH application ID:** 9994775
- **Project number:** 5K23HL147799-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Mabel Toribio
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $198,391
- **Award type:** 5
- **Project period:** 2019-08-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9994775

## Citation

> US National Institutes of Health, RePORTER application 9994775, Cardiometabolic Effects of Gender-Affirming Hormonal Therapy among Transgender Women with HIV (5K23HL147799-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9994775. Licensed CC0.

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