In Reply: Dr Danoff and colleagues raise the issue of HIV testing in transgender care. Considering the data from the meta-analysis of 29 studies, it would be worthwhile for guidelines and review articles to mention the higher prevalence of HIV reported among transgender persons. Optimally, all transgender individuals would have a primary care physician to take a careful sexual history, discuss HIV risks, and offer screening. In the absence of a primary care physician, another physician involved in the patient's care should assume this role.
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