scholarly journals Exploring barriers and facilitators to PrEP use among transgender women in two urban areas: implications for messaging and communication

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Sarah Bauerle Bass ◽  
Patrick J. Kelly ◽  
Jesse Brajuha ◽  
Luis Gutierrez-Mock ◽  
Kimberly Koester ◽  
...  
Keyword(s):  
Urban Areas ◽  
Preventive Measure ◽  
Transgender Women ◽  
Increased Risk ◽  
Prevention Interventions ◽  
Gender Affirmation ◽  
Trans Women ◽  
Hormone Use ◽  
Sex With Men ◽  
Exposure Prophylaxis

Abstract Background Trans women are at increased risk for HIV infection yet are less likely to use pre-exposure prophylaxis (PrEP) medication as a preventive measure. PrEP messaging and marketing has focused on men who have sex with men (MSM) or included trans women as a subset of MSM, ignoring the potential barriers to PrEP use unique to trans women. Little is known about how this group conceptualizes PrEP, what knowledge gaps still exist, and how trans women believe PrEP should be communicated to increase use. Methods This qualitative study conducted focus groups (n = 5) in Philadelphia and Sacramento with trans women to assess these issues. Results Twelve sub-themes were found related to five main domains, including PrEP knowledge, benefits, barriers, community-related considerations, and messaging/marketing. Findings indicate that knowledge of PrEP is still low and beliefs about PrEP’s effects on hormone use persist. Most importantly, participants voiced a demand for culturally appropriate trans-specific messages in HIV prevention interventions and communication. Conclusions Without acknowledging specific barriers to PrEP uptake among transgender women separate from those of MSM and incorporating gender affirmation into PrEP education, simply knowing PrEP is available may not motivate trans women to use PrEP. This has important implications for future efforts to communicate about PrEP with trans women.

scholarly journals Pre-Exposure Prophylaxis (PrEP) for HIV Infection in Cisgender and Transgender Women in the U.S.: A Narrative Review of the Literature

2021 ◽  
Author(s):  
Aleta Baldwin ◽  
Brenda Light ◽  
Waridibo E. Allison
Keyword(s):  
Hiv Infection ◽  
Population Group ◽  
Transgender Women ◽  
Sex And Gender ◽  
Individual Level ◽  
Pubmed Database ◽  
Trans Women ◽  
And Gender ◽  
Exposure Prophylaxis ◽  
The U.S

AbstractUsing a socioecological approach, this review describes the peer-reviewed literature on oral pre-exposure prophylaxis (PrEP) among both cisgender (cis women) and transgender women (trans women) in the U.S. A search of the PubMed database and HIV-related conference abstracts generated over 2,200 articles and abstracts. Of these, 103 fulfilled review inclusion criteria. Most of the existing research presents findings on individual-level factors associated with PrEP use such as willingness and perceived barriers. There was far less investigation of factors related to PrEP at more distal ecological levels. Though trans women are at greater risk of HIV infection than cisgender women, less is known about this population group with respect to PrEP despite their inclusion in many major clinical trials. Further, the literature is characterized by a persistent conflation of sex and gender which makes it difficult to accurately assess the reviewed research on HIV prevention and PrEP apart from risk group. Informed by these findings, we highlight specific opportunities to improve access to PrEP and reduce socioecological barriers to PrEP care engagement for cisgender and transgender women.

scholarly journals Limited awareness of pre-exposure prophylaxis among black men who have sex with men and transgender women in New York city

AIDS Care ◽  
2017 ◽  
Vol 30 (1) ◽  
pp. 9-17 ◽  
Author(s):  
Matthew Garnett ◽  
Yael Hirsch-Moverman ◽  
Julie Franks ◽  
Eleanor Hayes-Larson ◽  
Wafaa M. El-Sadr ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Black Men ◽  
York City ◽  
Transgender Women ◽  
Sex With Men ◽  
Exposure Prophylaxis

scholarly journals Influencing Factors of Pre-Exposure Prophylaxis Self-Efficacy Among Men Who Have Sex With Men

2019 ◽  
Vol 13 (2) ◽  
pp. 155798831984708 ◽  
Author(s):  
Dou Qu ◽  
Xiaoni Zhong ◽  
Minqing Lai ◽  
Jianghong Dai ◽  
Hao Liang ◽  
...  
Keyword(s):  
Influencing Factors ◽  
Rural Areas ◽  
Self Efficacy ◽  
Urban Areas ◽  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Anxiety Score ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

This research examines the level of pre-exposure prophylaxis (PrEP) self-efficacy among HIV-negative men who have sex with men (MSM) in China and identifies the influencing factors associated with the level of PrEP self-efficacy in terms of social-demographic characteristics and social psychological factors. The data were gathered from a baseline assessment of a longitudinal randomized controlled intervention trial. From April 2013 to March 2015, nonprobability sampling was used to recruit HIV-negative MSM at Chongqing, Guangxi, Xinjiang, and Sichuan in west China. A total of 1884 HIV-negative MSM were analyzed. Chi-square test and nonparametric rank sum test were used for univariate analysis. Multivariable linear regression analysis was used to discuss the factors that influence the level of PrEP self-efficacy. Overall levels of PrEP self-efficacy were low, and five factors were found to effect PrEP self-efficacy: age, residence, AIDS-related knowledge, PrEP-related motivation, and anxiety. Age and anxiety score were negatively related to PrEP self-efficacy. The higher the age and anxiety score, the lower the PrEP self-efficacy. AIDS-related knowledge and PrEP-related motivation were actively related to PrEP self-efficacy. The higher the knowledge and motivation score, the higher the PrEP self-efficacy. In addition, the PrEP self-efficacy level of MSM in rural areas is lower than that in urban areas. The lower level of self-efficacy in the MSM population needs to be improved. Pertinent interventions should be taken to promote the self-efficacy of PrEP in MSM, to enhance their willingness to take medicine, improve their medication adherence, and thus reduce HIV infection among MSM.

scholarly journals PrEP in Prisons: HIV prevention in incarcerated populations

2019 ◽  
Vol 16 (2) ◽  
pp. 199-206
Author(s):  
Jordan Parsons ◽  
Chelsea Cox
Keyword(s):  
Hiv Prevention ◽  
Harm Reduction ◽  
New Approach ◽  
Content Type ◽  
Harm Reduction Intervention ◽  
Access To Health ◽  
Prevention Interventions ◽  
High Risk Populations ◽  
Sex With Men ◽  
Exposure Prophylaxis

Purpose The purpose of this paper is to discuss the possibility of using pre-exposure prophylaxis (PrEP) as an HIV harm reduction intervention in prisons. PrEP is primarily discussed in relation to men who have sex with men (MSM), meaning other high-risk populations, such as prisoners, are often side-lined. The authors wanted to consider how it could prove beneficial beyond the MSM community. Design/methodology/approach First, the authors discuss whether the common objections to existing HIV harm reduction interventions in prisons, such as needle exchanges, are applicable to PrEP. The authors then apply common objections to the provision of PrEP in the general population to the provision of PrEP in a prison context in order to assess their strength. Finally, the authors discuss what the authors anticipate to be a key objection to PrEP in prisons: post-incarceration access. Findings The authors argue that both sets of common objections considered are easily refuted in the case of PrEP in prisons. The unique setting and nature of the intervention are such that it is without immediately apparent flaws. In addressing post-incarceration access, the authors suggest that a longitudinal consideration of a prisoner’s HIV risk undermines the objection. Originality/value This discussion is of importance due to the significantly heightened risk of HIV infection prisoners are subject to. Not only do effective HIV prevention interventions in prisons contribute to fair access to health for incarcerated individuals, but also to the wider fight against HIV. The authors demonstrate that PrEP has potential as a new approach and call for further research in this area.

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

2015 ◽  
Vol 20 (7) ◽  
pp. 1478-1488 ◽  
Author(s):  
Patricia A. Defechereux ◽  
◽  
Megha Mehrotra ◽  
Albert Y. Liu ◽  
Vanessa M. McMahan ◽  
...  
Keyword(s):  
Transgender Women ◽  
Sex With Men ◽  
Exposure Prophylaxis

scholarly journals “I wish to remain HIV negative”: Pre-exposure prophylaxis adherence and persistence in transgender women and men who have sex with men in coastal Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244226
Author(s):  
Makobu Kimani ◽  
Elise M. van der Elst ◽  
Oscar Chirro ◽  
Elizabeth Wahome ◽  
Fauz Ibrahim ◽  
...  
Keyword(s):  
Risk Behaviour ◽  
Healthcare Services ◽  
Transgender Women ◽  
Situational Factors ◽  
Sub Saharan Africa ◽  
Sexual Risk Behaviour ◽  
Sub Saharan ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

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.

High uptake of pre-exposure prophylaxis (PrEP) during early roll-out in Belgium: results from surveillance reports

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 80 ◽  
Author(s):  
Bea Vuylsteke ◽  
Thijs Reyniers ◽  
Catherine Lucet ◽  
Christiana Nöstlinger ◽  
Jessika Deblonde ◽  
...  
Keyword(s):  
Disability Insurance ◽  
Aggregated Data ◽  
Increased Risk ◽  
Event Driven ◽  
Sub Saharan ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
Roll Out

Background Since 1 June 2017, oral pre-exposure prophylaxis (PrEP) could be prescribed and reimbursed in Belgium as prophylactic medication for people who are at increased risk of HIV acquisition. The aim of this study was to determine the uptake of daily and event-driven PrEP in Belgium during the first 9 months of roll-out. Methods: Routine aggregated data on the number of reimbursement requests and the number of boxes of Truvada (Gilead Sciences, Cambridge, UK) delivered for PrEP through the Belgian pharmacies were obtained from the National Institute for Health and Disability Insurance. We also collected aggregated data from seven Aids Reference Centres (ARCs) currently providing most of the PrEP care in Belgium. Results: From 1 June 2017 to 28 February 2018, 1352 requests for reimbursement were approved by the National Institute for Health and Disability Insurance. Almost 98% of those who bought at least one box of 30 tablets of emtricitabine 200mg/tenofovir disoproxil fumarate 300mg (FTC/TDF) in a Belgian pharmacy were male, and most (67%) were between 30 and 50 years of age. According to data obtained from ARCs, the proportion of those choosing event-driven PrEP initially ranged between 29% and 73%. Conclusions: The uptake of PrEP in Belgium since the start of the roll-out in June 2017 has been high, and almost entirely limited to men who have sex with men, of whom 43% initially prefer a non-daily regimen. A better understanding is needed as to why other populations, such as sub-Saharan African migrants, are not accessing PrEP, as well as the development of a more sustainable PrEP delivery model.

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