Although PrEP is regarded in a positive light by many transgender people, actual PrEP uptake is extremely low among this population, and overall awareness remains lacking, according to a nationally representative survey conducted by U.S. researchers, the results of which were published in the Journal of Acquired Immune Deficiency Syndromes.
The survey, which was conducted by Gallup, involved 274 transgender people who were recruited among a national probability sample of Americans. Of those 274, 190 identified themselves as being HIV-negative and as having had sex within the past five years.
Within that sample of 190 people, 48% said they were familiar with the concept of taking tenofovir/emtricitabine (Truvada) as PrEP; trans men were more likely to be aware of PrEP (58%) than trans women (35%). Among respondents who were familiar with PrEP, 72% viewed it favorably, with trans women slightly more likely to hold that view (79%) than trans men (69%).
Despite these favorable views, only 3% reported taking biomedical HIV prevention. “This is concerning, especially among a sexually active probability sample of transgender people, given the particularly high rates of HIV among transgender women,” study authors commented.
Furthermore, 23% of 120 participants who met criteria for seroconversion risk said they had never been tested for HIV. Participants who looked for transgender health information online were more likely to meet Centers for Disease Control and Prevention (CDC) guidelines on HIV testing than those who did not seek such information. “These findings may indicate some success of HIV testing outreach programs that prioritize people at higher risk for acquiring HIV, focusing on those who are vulnerable to structural marginalization,” study authors concluded.
Given the high seroconversion rates in this population, the authors called on the CDC to clarify transgender-specific recommendations for HIV testing. In addition, gender-affirming outreach and HIV prevention services for the transgender community should be prioritized, they urged.