Acceptability of Antiretroviral Pre-exposure Prophylaxis from a Cohort of Sexually Experienced Young Transgender Women in Two U.S. Cities

AIDS Behav. 2018 Nov;22(11):3649-3657. doi: 10.1007/s10461-018-2127-0.

Abstract
in En , Spanish

Emtricitabine/tenofovir disoproxil fumarate as pre-exposure prophylaxis (PrEP) can prevent HIV infection among at-risk individuals, including young transgender women (YTW). We used baseline data from 230 HIV-uninfected YTW (ages 16-29 years) who were enrolled in Project LifeSkills during 2012-2015. We examined factors associated with perceived acceptability of PrEP use (mean score = 23.4, range 10.0-30.0). Participants were largely transgender women of color (67%) and had a mean age of 23 years (SD = 3.5). In an adjusted multiple linear regression model, PrEP interest (β = 3.7, 95% CI 2.2-5.2) and having a medical provider who meets their health needs (β = 2.9, 95% CI 1.3-4.4) was associated with higher PrEP acceptability scores, whereas younger age (21-25 vs 26-29 years) (β = -2.0, 95% CI - 3.6 to - 0.4) and reporting transactional sex in the past 4 months (β = - 1.5, 95% CI - 3.0 to - 0.1) was associated with lower PrEP acceptability scores (all p values < 0.05). Enhancing PrEP-related interventions by addressing the unique barriers to uptake among YTW of younger age or those with history of transactional sex could bolster PrEP acceptability for this population.

Emtricitabine/tenofovir disoproxil fumarate como profilaxis preexposición (PrEP) puede prevenir VIH en personas con alto riesgo, incluyendo mujeres jóvenes transgénero (YTW). Usamos datos de línea base de 230 YTW sin infección por VIH inscritas en Project LifeSkills para examinar las variables asociadas con aceptabilidad de PrEP (promedio=23.4, intervalo=10.0-30.0). Participantes eran mayormente mujeres transgénero de color (67%) con edad promedia de 23 años (DE=3.5). En un modelo de regresión lineal múltiple, interés en PrEP (β=3.7, 95% CI = 2.2–5.2) y tener un proveedor de atención medica que cumple con sus necesidades (β=2.9, 95% CI =1.3–4.4) era asociado con mayor aceptabilidad de PrEP, mientras que una edad menor (21-25 vs 26-29 años) (β=–2.0, 95% CI=-3.6–-0.4) y sexo transaccional en los últimos cuatro meses (β=–1.5, 95% CI =-3.0–-0.1) era asociado con menor aceptabilidad. Se necesitan intervenciones acerca de PrEP para YTW, sobre todo aquellas que han ejercido trabajo sexual, para aumentar la aceptabilidad de PrEP para esta población.

Keywords: HIV prevention; Pre-exposure prophylaxis; Transgender women; Young adults.

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / administration & dosage*
  • Boston
  • Chicago
  • Cities
  • Cohort Studies
  • Emtricitabine / administration & dosage*
  • Emtricitabine / therapeutic use
  • Female
  • HIV Infections / prevention & control*
  • HIV Infections / psychology
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • Pre-Exposure Prophylaxis / statistics & numerical data*
  • Sexual Behavior
  • Sexual Partners / psychology
  • Tenofovir / administration & dosage*
  • Tenofovir / therapeutic use
  • Transgender Persons / psychology*
  • Transgender Persons / statistics & numerical data
  • Young Adult

Substances

  • Anti-HIV Agents
  • Tenofovir
  • Emtricitabine