Awareness and utilization of pre-exposure prophylaxis and HIV prevention services among transgender and non-binary adolescent and young adults

Arianna Rodriguez; Keith J Horvath; Nadia Dowshen; Raina Voss; Jonathan Warus; Megan Jacobs; Kacie M Kidd; David J Inwards-Breland; Jill Blumenthal

doi:10.3389/frph.2023.1150370

Awareness and utilization of pre-exposure prophylaxis and HIV prevention services among transgender and non-binary adolescent and young adults

Front Reprod Health. 2024 Jan 22:5:1150370. doi: 10.3389/frph.2023.1150370. eCollection 2023.

Authors

Arianna Rodriguez¹, Keith J Horvath², Nadia Dowshen^{3

4}, Raina Voss⁵, Jonathan Warus⁶, Megan Jacobs⁷, Kacie M Kidd⁸, David J Inwards-Breland⁹, Jill Blumenthal¹

Affiliations

¹ Department of Medicine, University of California San Diego, La Jolla, CA, United States.
² Department of Psychology, San Diego State University, San Diego, CA, United States.
³ Craig-Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
⁴ Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
⁵ Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.
⁶ Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA, United States.
⁷ Department of Pediatrics, Oregon Health and Science University, Portland, OR, United States.
⁸ Division of Adolescent Medicine, WVU Medicine Children's, Morgantown, WV, United States.
⁹ Department of Pediatrics, Rady Children's Hospital, UCSD, La Jolla, CA, United States.

Abstract

Introduction: Transgender and gender non-binary (TGNB) individuals are disproportionally affected by HIV and face high rates of discrimination and stigmatization, resulting in limited access to HIV prevention services. Pre-exposure prophylaxis (PrEP) is highly efficacious for reducing the risk of HIV transmission. However, little research is available regarding PrEP awareness and utilization among TGNB adolescents and young adults (AYA).

Methods: TGNB AYA ages 15-24 years old were recruited between December 2021 and November 2022 for participation in a one-time, anonymous online survey study to assess PrEP awareness and perceptions, as well as barriers to its use. Participants were recruited from seven academic centers offering gender-affirming care to TGNB AYA across the United States.

Results: Of the 156 TGNB AYA individuals who completed the survey, most (67%) were aware of PrEP; however, few (7%) had been prescribed PrEP. Many (60%) had not spoken to a medical provider and, even if the medication was free and obtained confidentially, most participants did not plan to take PrEP due to low perceived HIV risk, lack of PrEP knowledge, and concern about interactions between their hormone therapy and PrEP.

Discussion: These findings underscore the need for broad PrEP educational efforts for both TGNB AYA and their providers to improve knowledge, identify potential PrEP candidates among TGNB AYA and improve access by addressing identified barriers.

Keywords: adolescents; awareness; non-binary; pre-exposure prophylaxis; transgender; young adults.

Grants and funding

The cost of providing $10 electronic gift card to all participants who completed the study was covered by a grant from the Hispanic Center of Excellence at the University of California San Diego in La Jolla, CA provided to David J. Inwards-Breland MD MPH.