HIV pre-exposure prophylaxis (PrEP) awareness and acceptability among trans women: a review

AIDS Care. 2019 Oct;31(10):1234-1240. doi: 10.1080/09540121.2019.1612014. Epub 2019 May 1.


Transgender (trans) women are disproportionally burdened by the HIV epidemic due to complex structural, psychosocial and biological factors. HIV pre-exposure prophylaxis (PrEP) is a biomedical prevention approach for people at substantial risk of acquiring HIV. This literature review assessed awareness, willingness to use, and barriers and facilitators for PrEP acceptability among trans women. A search was conducted through five databases and included studies with primary data and disaggregate results for trans women. Of 255 retrieved citations, 17 met the inclusion criteria and were included. Low to moderate knowledge about PrEP was observed among studies. However, willingness to use PrEP was predominantly high. Frequent barriers to PrEP acceptability included concerns about side effects, cost, hormone therapy, adherence, PrEP-related stigma and interaction with healthcare workers. Facilitators included perceived reduction of HIV risk, fear of HIV/AIDS and reduced dependence on partners. Findings suggest elevated interest in PrEP and highlight important barriers and facilitators that should be specifically addressed to optimize PrEP uptake and use among this highly vulnerable population.

Keywords: HIV prevention; PrEP; Pre-exposure prophylaxis; acceptability; awareness; transgender women.

Publication types

  • Review

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Female
  • HIV Infections / prevention & control*
  • HIV Infections / psychology
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Medication Adherence
  • Patient Acceptance of Health Care / psychology*
  • Pre-Exposure Prophylaxis*
  • Sexual Partners
  • Social Stigma
  • Transgender Persons / psychology*