Depression and Oral FTC/TDF Pre-exposure Prophylaxis (PrEP) Among Men and Transgender Women Who Have Sex With Men (MSM/TGW)

Background Transgender women (TGW) and men who have sex with men (MSM) in sub-Saharan Africa have high HIV acquisition risks and can benefit from daily pre-exposure prophylaxis (PrEP). We assessed PrEP adherence by measuring tenofovir-diphosphate (TFV-DP) levels and explore motives for PrEP persistence in TGW and MSM. Methods Participants were enrolled in a one-year PrEP programme and made quarterly visits irrespective of whether they were still using PrEP. At their month 6 visit, participants provided a dried blood spot to test for TFV-DP levels; protective levels were defined as those compatible with ≥4 pills per week (700–1249 fmol/punch). Before TFV-DP levels were available, a sub-set of these participants were invited for an in-depth interview (IDI). Semi-structured IDI topic guides were used to explore motives to uptake, adhere to, and discontinue PrEP. IDI data were analyzed thematically. Results Fifty-three participants (42 MSM and 11 TGW) were enrolled. At month 6, 11 (20.7%) participants (8 MSM and 3 TGW) were lost to follow up or stopped taking PrEP. Any TFV-DP was detected in 62.5% (5/8) of TGW vs. 14.7% of MSM (5/34, p = 0.01). Protective levels were detected in 37.5% of TGW (3/8), but not in any MSM. Nineteen IDI were conducted with 7 TGW and 9 MSM on PrEP, and 1 TGW and 2 MSM off PrEP. Unplanned or frequent risky sexual risk behaviour were the main motives for PrEP uptake. Among participants on PrEP, TGW had a more complete understanding of the benefits of PrEP. Inconsistent PrEP use was attributed to situational factors. Motives to discontinue PrEP included negative reactions from partners and stigmatizing healthcare services. Conclusion While MSM evinced greater adherence challenges in this PrEP programme, almost 40% of TGW were protected by PrEP. Given high HIV incidences in TGW these findings hold promise for TGW PrEP programming in the region.

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Awareness and Willingness to Use Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men and Transgender Women in Brazil

AIDS and Behavior ◽

10.1007/s10461-016-1516-5 ◽

2016 ◽

Vol 21 (5) ◽

pp. 1278-1287 ◽

Cited By ~ 41

Author(s):

Brenda Hoagland ◽

◽

Raquel B. De Boni ◽

Ronaldo I. Moreira ◽

José Valdez Madruga ◽

...

Keyword(s):

Transgender Women ◽

Sex With Men ◽

Willingness To Use ◽

Exposure Prophylaxis

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Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men

AIDS and Behavior ◽

10.1007/s10461-017-1690-0 ◽

2017 ◽

Vol 21 (5) ◽

pp. 1236-1246 ◽

Cited By ~ 97

Author(s):

Lisa A. Eaton ◽

Seth C. Kalichman ◽

Devon Price ◽

Stephanie Finneran ◽

Aerielle Allen ◽

...

Keyword(s):

White Men ◽

Transgender Women ◽

Black And White ◽

Conspiracy Beliefs ◽

Sex With Men ◽

Exposure Prophylaxis

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HIV pre-exposure prophylaxis in men who have sex with men and transgender women: a secondary analysis of a phase 3 randomised controlled efficacy trial

The Lancet Infectious Diseases ◽

10.1016/s1473-3099(14)70025-8 ◽

2014 ◽

Vol 14 (6) ◽

pp. 468-475 ◽

Cited By ~ 87

Author(s):

Susan P Buchbinder ◽

David V Glidden ◽

Albert Y Liu ◽

Vanessa McMahan ◽

Juan V Guanira ◽

...

Keyword(s):

Secondary Analysis ◽

Transgender Women ◽

Efficacy Trial ◽

Phase 3 ◽

Sex With Men ◽

Randomised Controlled ◽

Exposure Prophylaxis

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Preferences for pre-exposure prophylaxis (PrEP) among men who have sex with men and transgender women at risk of HIV infection: a multicentre protocol for a discrete choice experiment in Brazil

BMJ Open ◽

10.1136/bmjopen-2021-049011 ◽

2021 ◽

Vol 11 (9) ◽

pp. e049011

Author(s):

Claudia Cristina de Aguiar Pereira ◽

Thiago Silva Torres ◽

Paula Mendes Luz ◽

Brenda Hoagland ◽

Alessandro Farias ◽

...

Keyword(s):

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Risk Behaviour ◽

Transgender Women ◽

Second Phase ◽

Qualitative Approaches ◽

Sex With Men ◽

Exposure Prophylaxis ◽

Choice Tasks

IntroductionPre-exposure prophylaxis (PrEP) is an important and well-established prevention strategy for sexual acquisition of HIV. In Brazil, transgender women (TGW) and men who have sex with men (MSM) bear the largest burden among key populations. Little is known about preferences for PrEP characteristics in these vulnerable populations in Latin America. The goal of this study is to investigate preferences of TGW and MSM with respect to PrEP characteristics, whether current user or not, and to assess any attributes and levels that may improve the decision to start using PrEP (uptake) and optimal continuity of use (adherence), which are important dimensions for PrEP success.Methods and analysisWe hereby outline the protocol of a discrete choice experiment (DCE) to be conducted among TGW and MSM in Brazil. The study will be carried out in two phases. The first phase involves literature review and qualitative approaches including in-depth interviews to inform the development of the DCE (attributes and levels). The second phase entails the DCE survey and supporting questions pertaining to sociodemographic and risk behaviour information. The survey is aimed at current PrEP users and non-users, consisting of two modes of administration: face to face in five Brazilian capitals (Rio de Janeiro, Brasília, Manaus, Porto Alegre and Salvador) and online targeting the entire country. A D-efficient zero-prior blocked experimental design will be used to select 60 paired-profile DCE choice tasks, in which participants will be randomly assigned to one of four groups and presented with a set of 15 choice tasks. The planned sample size is 1000 volunteers.Ethics, timeline and disseminationThe study was approved by Comitê de Ética em Pesquisa—Instituto Nacional de Infectologia Evandro Chagas—INI/FIOCRUZ, CEP/INI, CAAE 28416220.2.1001.5262, approval number 3.979.759 in accordance with the Comissão Nacional de Ética em Pesquisa (CONEP—Brazilian National Board of Research Ethics). The study will be conducted between 2020 and 2021. The results will be disseminated to the scientific community and to the public in general through publications in published in peer-reviewed journals and in scientific conferences.

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Pre-exposure prophylaxis uptake for HIV infection prevention among young men who have sex with men and transgender women in Bangkok, Thailand

Journal of Health Research ◽

10.1108/jhr-10-2019-0242 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Naruemon Auemaneekul ◽

Sirirat Lertpruek ◽

Pratana Satitvipawee ◽

Nik AA Tuah

Keyword(s):

Behavioral Control ◽

Young Men ◽

Transgender Women ◽

Perceived Behavioral Control ◽

Snowball Sampling ◽

Content Type ◽

Factors Associated ◽

Voluntary Counseling And Testing ◽

Sex With Men ◽

Exposure Prophylaxis

PurposeThe purpose of this study aimed to assess factors associated with the intention to take pre-exposure prophylaxis (PrEP) among Thai young men who have sex with men (YMSM) and transgender women (TGW) in Bangkok.Design/methodology/approachThe study surveyed 350 sexually active Thai YMSM and TGW aged between 18 and 24 years registered with a nongovernmental organization (NGO) working with the MSM community. Data were collected using snowball sampling from four venues. Participants completed a self-administered questionnaire. Logistic regression was used to evaluate factors associated with the intention to take PrEP daily.FindingsThe results showed that of all those surveyed, n = 310 (88%) participated. The median age was 21 years. In all, 18% of participants had heard about PrEP, and 36% correctly identified that PrEP is used for prevention. After receiving information, 31% intended to take daily PrEP and the Voluntary Counseling and Testing (VCT) rate was 35.5%. Factors significantly associated with intention to take daily PrEP were history of HIV testing (adjusted odds ratio (AOR), 2.3, 95% CI, 1.3–4.1), and high perceived behavioral control of PrEP adherence scores (AOR 3.0, 95% CI, 1.8–5.2).Originality/valueThis study showed that intention to take and knowledge of daily PrEP among YMSM and TGW was low. Promoting health education to YMSM and TGW about PrEP and MSM-friendly VCT services are needed to effectively implement PrEP in HIV prevention programs.

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Prepped for PrEP? Acceptability, continuation and adherence among men who have sex with men and transgender women enrolled as part of Vietnam's first pre-exposure prophylaxis program

Sexual Health ◽

10.1071/sh20167 ◽

2021 ◽

Vol 18 (1) ◽

pp. 104 ◽

Cited By ~ 1

Author(s):

Kimberly Elizabeth Green ◽

Long Hoang Nguyen ◽

Huong Thu Thi Phan ◽

Bao Ngoc Vu ◽

Minh Hung Tran ◽

...

Keyword(s):

Transgender Women ◽

Sex Partners ◽

Average Income ◽

Prevention Services ◽

Key Population ◽

Multivariable Regression ◽

Sex With Men ◽

Public Clinics ◽

Exposure Prophylaxis ◽

Roll Out

Background HIV prevalence among men who have sex with men (MSM) and transgender women (TGW) in Vietnam is high, whereas coverage of effective HIV prevention services has been inadequate. Studies have measured MSM and TGW demand for pre-exposure prophylaxis (PrEP) services, which led to the design of the first ever PrEP program in Vietnam, Prepped for PrEP (P4P). Methods: In March 2017, PrEP services were offered in Ho Chi Minh City as part of the P4P demonstration project, enabling same-day enrolment in three key population (KP)-led clinics and four public clinics. P4P aimed to assess acceptability and feasibility of PrEP services through calculating the rate of PrEP enrolment over time, and quarterly measures of continuation and adherence over an 18-month period. Results: A total of 1069 MSM and 62 TGW were enrolled in P4P. Average monthly PrEP enrolment among MSM increased five-fold from the first 3 months (March–June 2017) to the last 3 months of active enrolment (March–June 2018), whereas for TGW, no increased trend in PrEP enrolment per quarter was seen. Self-reported PrEP adherence was >90% at all time points among MSM, but varied from 11.1% to 88.9% among TGW. PrEP continuation was calculated at months 3, 6, 9, 12, 15 and 18. For MSM, it was 88.7% at month 3, 68.8% at month 12 and 46.6% at month 18, whereas for TGW, it was 87.1%, 54.8% and 52.8%, respectively. Multivariable regression identified that MSM with lower-than-average income (adjusted odds ratio (aOR) 2.38 (95% confidence interval (CI): 1.59–3.54), P = 0.000), aged >30 years (aOR 2.03 (95% CI: 1.30–3.40), P = 0.007) and with an increasing number of sex partners (aOR: 1.06 (1.01–1.11), P = 0.011) had greater odds of remaining on PrEP. For TGW, being aged >30 years was associated with continuing on PrEP (aOR 5.62 (95% CI: 1.05–29.9), P = 0.043). Conclusions: We found PrEP to be highly acceptable among MSM and moderately acceptable among TGW. Continuation rates were relatively high for the first roll-out of PrEP; however, those aged ≤30 years were much more likely to discontinue services. Scaling-up PrEP through differentiated and community-led and engaged PrEP service delivery will be key to effectively increase access and uptake over the next 5 years.

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