Age Is Associated With HIV Sexual Risk Behaviors Among Trans Women in Los Angeles County

Little is known about how HIV risk varies among trans women of different ages. From January 2010 to February 2021, 2,242 trans women were assessed via outreach encounters consisting of health education and risk reduction information, and queries of recent sexual behaviors. Generalized linear models provide adjusted rates of engagement in condomless anal intercourse (CAI), in exchange sex, and CAI with exchange partners in the past 30 days for each year from age 18 to 60. Most participants identified as Hispanic/Latina (52%) and most were HIV negative (80%). Engagement in exchange sex remained prevalent from participants’ early 20s through their mid-40s, though CAI with such partners never exceeded an average estimated prevalence of 15%. Condomless behaviors with non-exchange partners was more common, with at least 20% reporting engagement in non-exchange CAI regardless of age. The need for trans-specific sexual risk reduction interventions that take age into account is underscored.

PrEP discontinuation among Latino/a and Black MSM and transgender women: A need for PrEP support services

Purpose Disparities persist in HIV infection among Black and Latino men who have sex with men (BLMSM) and Black and Latina transgender women (BLTW). Increasing uptake and subsequent consistent use of pre-exposure prophylaxis (PrEP), an effective biomedical strategy for preventing HIV acquisition, can dramatically reduce HIV incidence in these populations. The purpose of this study was to explore reasons for PrEP discontinuation among BLMSM and BLTW living in Los Angeles County to inform the development of support services for these populations to remain persistent with their PrEP regimen. Methods In-depth, semi-structured interviews were conducted with 15 BLMSM and 7 BLTW who reported either temporary or indefinite PrEP discontinuation. A thematic analysis approach was used to analyze qualitative data. Results Four themes emerged related to reasons for PrEP discontinuation, including: (1) lower perceived HIV risk related to changes in sexual behavior; (2) structural or logistical barriers (e.g., lapse or loss of health insurance, cost, difficulty navigating complex medical systems); (3) anticipated and experienced medication side effects, with a sub-theme of interactions between PrEP and feminizing hormone medications; and (4) challenges with medication adherence. Conclusions PrEP is an important prevention tool for BLMSM and BLTW, particularly during periods of heightened HIV risk. However, both individual (e.g., inability to adhere to medication, changes in HIV sexual risk behaviors) and structural/logistical (e.g., loss of insurance, navigating complex medical systems) factors can cause temporary or indefinite PrEP discontinuation. Additional support services, beyond those offered by medical providers, are needed to help BLMSM and BLTW PrEP users overcome barriers to discontinuation and assist them to remain persistent with their PrEP regimen. We describe potential options for support services such as PrEP case management, expanded PrEP navigation services, or text messaging services.

Assessment of Risk Behaviors for HIV Infection among Undergraduate Students at a Historically Black University

Aims: This study aimed to assess and compare risk behaviors for HIV Infection among undergraduate students by gender at a historically black university. Study Design: A cross-sectional survey. Place and Duration of Study: This study was conducted from January 10, 2016 to September 30, 2016. Participants were selected through convenience sampling among undergraduate students of Jackson State University (JSU). Methodology: Sample: We included 400 undergraduate students (141 males, 259 females; age range 18-57 years). Data were collected using a validated self-administered standardized questionnaire that was designed to measure their risk behaviors for HIV Infection. Results: Over seventy five percent of undergraduate students in this study have had at least one risk behavior related to HIV infection transmission. The engagement of these students in HIV sexual risk behaviors were not varied by gender (Chi-square test = 2.76; P = 0.1). However, participants engaged in various risk behaviors related to HIV infection transmission such as multiple sexual partners, unprotected sexual intercourse, low and inconsistent condom use. Conclusion: We concluded that about 75.8% of the students have had at least one risk behavior related to HIV infection and engaged in various risk behaviors related to HIV infection transmission. The engagement of these students in HIV sexual risk behaviors were not varied by gender. This investigation calls for sustained effective youth appealing interventions tailored toward addressing various risk behaviors identified in this study.