Most transgender women of color surveyed in two major U.S. cities are willing to use PrEP, but few are currently doing so, a small study published in Journal of Acquired Immune Deficiency Syndromes found.
Researchers interviewed and conducted HIV testing among 201 African American and Latina transgender women in two cities: Baltimore, Maryland; and Washington, D.C. HIV prevalence was high: 112 participants were living with HIV, including 10 people who were newly diagnosed through their participation. Of the 201 total study participants, 87% had heard of PrEP, and 75% of the 89 HIV-negative participants said they were willing to try it. However, only 17% of the study participants who had previously heard of PrEP reported ever taking it.
Among respondents who did not want to take PrEP, concern regarding potential interactions between PrEP and hormone therapy was the most common reason (65%). By comparison, such interactions were experienced by 15% of the 26 study participants who had ever taken PrEP.
Greater HIV knowledge and legal gender affirmation (i.e., a person whose desired name and gender are present on their legal identification) were associated with lower willingness to try PrEP, while a higher willingness was seen among people who exchanged sex for goods, money, or shelter.
The study authors hypothesized that women with gender-affirming IDs may feel that PrEP messages targeting MSM are not relevant. Meanwhile, interviews suggested that HIV-aware trans women may prefer condoms to prevent both HIV and other STIs.
The authors called for further research into barriers to PrEP uptake, as well as community involvement to address prevention, concluding, "[t]ransgender community leadership, peer support, and collaboration are key to successful HIV prevention efforts."