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. 2023 Apr 21;20(1):24.
doi: 10.1186/s12981-023-00516-0.

A cross-sectional analysis of psychosocial and structural barriers and facilitators associated with PrEP use among a sample of transgender women in Chicago, IL

Lisa M Kuhns  1   2 , Judy Perloff  3 , Amy K Johnson  4   5 , Josie Lynne Paul  3 , Kevin Pleasant  3 , Kaiji Evans  3 , Damian J Denson  6 , Deborah J Gelaude  6 , Patricia A Bessler  6 , Rose Diskin  5 , Marbella Cervantes  5 , Robert Garofalo  4   5 , Anna L Hotton  7
Affiliations

A cross-sectional analysis of psychosocial and structural barriers and facilitators associated with PrEP use among a sample of transgender women in Chicago, IL

Lisa M Kuhns et al. AIDS Res Ther. .

Abstract

Background: Expanding pre-exposure prophylaxis (PrEP) among transgender women in the United States is an important strategy to meet national HIV prevention goals, however self-reported use of PrEP is low in this group.

Methods: This study reports the findings of a cross-sectional analysis of the relationship of barriers as well as facilitators to recent PrEP use among transgender women enrolled in an evaluation of the TransLife Care project (Chicago, Illinois), a structural intervention designed to meet basic needs. We computed multivariable prevalence ratios for barriers, facilitators and recent PrEP use, controlling for demographics.

Results: Findings suggest that psychosocial and structural barriers, including moderate/high alcohol use, stimulant use, and history of incarceration were all positively associated with recent PrEP use among urban transgender women. In addition, a psychosocial facilitator, gender affirmation, was positively associated with recent PrEP use, while, while collective self-esteem, a was negatively associated with it. Finally, common indications for PrEP have high sensitivity, but low specificity and predictive value for identifying those on PrEP.

Conclusion: We conclude that despite a large gap in PrEP use among those with indications, individuals experiencing psychosocial and structural barriers are more likely to use PrEP, and facilitators, such as psychological sense of affirmed gender may support its use.

Trial registration: N/A.

Keywords: HIV; Pre-exposure prophylaxis; Transgender women.

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Conflict of interest statement

The authors declare no competing interests.

References

    1. Centers for Disease Control and Prevention. HIV infection, risk, prevention, and testing behaviors among transgender women - national HIV behavioral surveillance, 7 U.S. cities, 2019–2020. http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html; 2021 April.
    1. Fauci AS, Redfield RR, Sigounas G, Weahkee MD, Giroir BP. Ending the HIV Epidemic: a plan for the United States. JAMA. 2019;321(9):844–5. doi: 10.1001/jama.2019.1343]. - DOI - PubMed
    1. Kuhns LM, Reisner SL, Mimiaga MJ, Gayles T, Shelendich M, Garofalo R. Correlates of PrEP indication in a Multi-Site Cohort of Young HIV-Uninfected Transgender Women. AIDS Behav. 2016;20(7):1470–7. doi: 10.1007/s10461-015. - DOI - PMC - PubMed
    1. Parrish KC, Johnson HZ, Williams SL. PrEP navigation continuum among men who have sex with men, trans women, and people with alternative gender identities in three California counties. Eval Program Plann. 2022;90:101998doi. doi: 10.1016/j.evalprogplan.2021.101998]. - DOI - PubMed
    1. Malone J, Reisner SL, Cooney EE, Poteat T, Cannon CM, Schneider JS, et al. Perceived HIV Acquisition Risk and Low Uptake of PrEP among a cohort of Transgender Women with PrEP indication in the Eastern and Southern United States. J Acquir Immune Defic Syndr. 2021;88(1):10–8. doi: 10.1097/qai.0000000000002726]. - DOI - PMC - PubMed

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