Improved PrEP Awareness and Use among Trans Women in San Francisco, California

Erin C Wilson; Christopher J Hernandez; Susan Scheer; Dillon Trujillo; Sean Arayasirikul; Sofia Sicro; Willi McFarland

doi:10.1007/s10461-021-03417-3

Improved PrEP Awareness and Use among Trans Women in San Francisco, California

AIDS Behav. 2022 Feb;26(2):596-603. doi: 10.1007/s10461-021-03417-3. Epub 2021 Aug 14.

Authors

Erin C Wilson¹, Christopher J Hernandez², Susan Scheer³, Dillon Trujillo², Sean Arayasirikul^{2

4

5}, Sofia Sicro², Willi McFarland^{2

6}

Affiliations

¹ Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA, 94102, USA. Erin.wilson@sfdph.org.
² Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA, 94102, USA.
³ HIV Epidemiology Section, San Francisco Department of Public Health, San Francisco, CA, USA.
⁴ Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.
⁵ Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
⁶ Department of Biostatistics and Epidemiology, University of California San Francisco, San Francisco, CA, USA.

Abstract
in English, Spanish

Transgender women face a serious risk of HIV infection. Despite this, there is limited knowledge and use of Pre-exposure prophylaxis (PrEP). We measured the continuity of prevention across services in the PrEP cascade and correlates of PrEP use among trans women in San Francisco enrolled in the 2019/20 National HIV Behavioral Surveillance Study. Knowledge and use of PrEP among trans women in San Francisco increased in recent years; almost all (94.0%) had heard about PrEP, 64.7% had discussed PrEP with a healthcare provider, and 44.8% had taken PrEP in the past 12 months. PrEP use was associated with participation in a PrEP demonstration project (aOR = 31.44, p = 0.001) and condomless receptive anal intercourse (aOR = 3.63, p = 0.024). Injection drug use was negatively associated (aOR = 0.19, p = 0.014). Efforts are needed to combat the gender-based stigma and discrimination faced by trans women, which can result in avoidance and mistrust of the medical system.

Las mujeres trans enfrentan un grave riesgo de infección por el VIH. A pesar de ello, hay conocimiento y utilización limitada de la profilaxis previa a la exposición (PrEP). Medimos la continuidad de prevención a través de los servicios en la cascada de PrEP y los correlatos del uso de PrEP entre mujeres trans en San Francisco inscritas en el Estudio Nacional de Vigilancia del Comportamiento del VIH en 2019/20. El conocimiento y el uso de PrEP entre las mujeres trans en San Francisco aumentó en los últimos años; casi todas (94.0%) habían escuchado sobre PrEP, el 64.7% habían hablado de PrEP con un proveedor de atención médica y el 44.8% había tomado PrEP en los últimos 12 meses. El uso de PrEP se asoció con el uso actual con participación en un proyecto de demostración de PrEP (ORa = 31.44, p = 0.001) y el coito anal receptivo sin condón (ORa = 3.63, p = 0.024). El uso de drogas inyectables se asoció negativamente (ORa = 0.19, p = 0.014). Se necesitan esfuerzos para combatir el estigma y la discriminación basados en el género que enfrentan las mujeres trans, que pueden resultar en la evitación y desconfianza en el sistema medico.”.

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

MeSH terms

Anti-HIV Agents* / therapeutic use
Female
HIV Infections* / drug therapy
HIV Infections* / epidemiology
HIV Infections* / prevention & control
Homosexuality, Male
Humans
Male
Pre-Exposure Prophylaxis*
San Francisco / epidemiology
Transgender Persons*

Substances

Anti-HIV Agents

Abstract in English, Spanish

MeSH terms

Substances

Grants and funding

Abstract
in English, Spanish