Perceived HIV Acquisition Risk and Low Uptake of PrEP Among a Cohort of Transgender Women With PrEP Indication in the Eastern and Southern United States
Preexposure prophylaxis (PrEP) is effective in preventing HIV among adherent users. However, PrEP uptake among transgender women is low, and current prescribing guidelines from the Centers for Disease Control and Prevention (CDC) are not specific to transgender women. Self-perceived risk of HIV amon...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2021-09, Vol.88 (1), p.10-18 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
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| creator | Malone, Jowanna Reisner, Sari L. Cooney, Erin E. Poteat, Tonia Cannon, Christopher M. Schneider, Jason S. Radix, Asa Mayer, Kenneth H. Haw, J. Sonya Althoff, Keri N. Wawrzyniak, Andrew J. Beyrer, Chris Wirtz, Andrea L. |
| description | Preexposure prophylaxis (PrEP) is effective in preventing HIV among adherent users. However, PrEP uptake among transgender women is low, and current prescribing guidelines from the Centers for Disease Control and Prevention (CDC) are not specific to transgender women. Self-perceived risk of HIV among those who are PrEP-indicated is not well understood.
This cross-sectional analysis included 1293 transgender women screened at baseline from March 2018 to May 2020 for a multisite, prospective cohort study. We compared the prevalence of PrEP indication using current CDC prescribing criteria versus transgender women-specific criteria developed by study investigators with community input. We identified factors associated with study-specific PrEP indication and factors associated with self-perceived low to no HIV risk among those who were PrEP-indicated. We also calculated descriptive statistics to depict the PrEP care continuum.
PrEP indication prevalence using transgender women-specific criteria was 47% (611), 155 more than who were identified using the CDC criteria. Eighty-three percent were aware of PrEP, among whom 38% had ever used PrEP. Among PrEP ever users, 63% were using PrEP at the time of the study. There were 66% of current PrEP users who reported 100% adherence within the previous 7 days. Among those who were PrEP-indicated, 13% were using and adherent to PrEP at the time of the study. More than half (55%) of PrEP-indicated participants had low or no self-perceived HIV risk.
These findings suggest that further guidance is needed for health care providers in prescribing PrEP to transgender women. Greater uptake and adherence are also needed for optimal effectiveness. |
| doi_str_mv | 10.1097/QAI.0000000000002726 |
| format | Article |
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This cross-sectional analysis included 1293 transgender women screened at baseline from March 2018 to May 2020 for a multisite, prospective cohort study. We compared the prevalence of PrEP indication using current CDC prescribing criteria versus transgender women-specific criteria developed by study investigators with community input. We identified factors associated with study-specific PrEP indication and factors associated with self-perceived low to no HIV risk among those who were PrEP-indicated. We also calculated descriptive statistics to depict the PrEP care continuum.
PrEP indication prevalence using transgender women-specific criteria was 47% (611), 155 more than who were identified using the CDC criteria. Eighty-three percent were aware of PrEP, among whom 38% had ever used PrEP. Among PrEP ever users, 63% were using PrEP at the time of the study. There were 66% of current PrEP users who reported 100% adherence within the previous 7 days. Among those who were PrEP-indicated, 13% were using and adherent to PrEP at the time of the study. More than half (55%) of PrEP-indicated participants had low or no self-perceived HIV risk.
These findings suggest that further guidance is needed for health care providers in prescribing PrEP to transgender women. Greater uptake and adherence are also needed for optimal effectiveness.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000002726</identifier><identifier>PMID: 34397742</identifier><language>eng</language><publisher>United States: JAIDS Journal of Acquired Immune Deficiency Syndromes</publisher><subject>Adult ; Anti-HIV Agents - administration & dosage ; Anti-HIV Agents - therapeutic use ; Cohort Studies ; Criteria ; Cross-Sectional Studies ; Disease control ; Female ; Health Belief Model ; Health care ; Health Knowledge, Attitudes, Practice ; Health risks ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - prevention & control ; HIV Infections - psychology ; Human immunodeficiency virus ; Humans ; Indication ; Male ; Medication Adherence - psychology ; Medication Adherence - statistics & numerical data ; Middle Aged ; Pre-Exposure Prophylaxis - methods ; Pre-Exposure Prophylaxis - statistics & numerical data ; Prevalence ; Prophylaxis ; Prospective Studies ; Risk perception ; Statistical analysis ; Transgender persons ; Transgender Persons - psychology ; United States - epidemiology</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2021-09, Vol.88 (1), p.10-18</ispartof><rights>JAIDS Journal of Acquired Immune Deficiency Syndromes</rights><rights>Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4263-f209ebd67567a3dc126b63b4bd471c34b7ccfadd45c8297124bc7768461de37f3</citedby><cites>FETCH-LOGICAL-c4263-f209ebd67567a3dc126b63b4bd471c34b7ccfadd45c8297124bc7768461de37f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00126334-202109010-00003$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>314,776,780,4594,27903,27904,65210</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34397742$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Malone, Jowanna</creatorcontrib><creatorcontrib>Reisner, Sari L.</creatorcontrib><creatorcontrib>Cooney, Erin E.</creatorcontrib><creatorcontrib>Poteat, Tonia</creatorcontrib><creatorcontrib>Cannon, Christopher M.</creatorcontrib><creatorcontrib>Schneider, Jason S.</creatorcontrib><creatorcontrib>Radix, Asa</creatorcontrib><creatorcontrib>Mayer, Kenneth H.</creatorcontrib><creatorcontrib>Haw, J. Sonya</creatorcontrib><creatorcontrib>Althoff, Keri N.</creatorcontrib><creatorcontrib>Wawrzyniak, Andrew J.</creatorcontrib><creatorcontrib>Beyrer, Chris</creatorcontrib><creatorcontrib>Wirtz, Andrea L.</creatorcontrib><creatorcontrib>American Cohort to Study HIV Acquisition Among Transgender Women (LITE) Study Group</creatorcontrib><creatorcontrib>For the American Cohort to Study HIV Acquisition Among Transgender Women (LITE) Study Group</creatorcontrib><title>Perceived HIV Acquisition Risk and Low Uptake of PrEP Among a Cohort of Transgender Women With PrEP Indication in the Eastern and Southern United States</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>Preexposure prophylaxis (PrEP) is effective in preventing HIV among adherent users. However, PrEP uptake among transgender women is low, and current prescribing guidelines from the Centers for Disease Control and Prevention (CDC) are not specific to transgender women. Self-perceived risk of HIV among those who are PrEP-indicated is not well understood.
This cross-sectional analysis included 1293 transgender women screened at baseline from March 2018 to May 2020 for a multisite, prospective cohort study. We compared the prevalence of PrEP indication using current CDC prescribing criteria versus transgender women-specific criteria developed by study investigators with community input. We identified factors associated with study-specific PrEP indication and factors associated with self-perceived low to no HIV risk among those who were PrEP-indicated. We also calculated descriptive statistics to depict the PrEP care continuum.
PrEP indication prevalence using transgender women-specific criteria was 47% (611), 155 more than who were identified using the CDC criteria. Eighty-three percent were aware of PrEP, among whom 38% had ever used PrEP. Among PrEP ever users, 63% were using PrEP at the time of the study. There were 66% of current PrEP users who reported 100% adherence within the previous 7 days. Among those who were PrEP-indicated, 13% were using and adherent to PrEP at the time of the study. More than half (55%) of PrEP-indicated participants had low or no self-perceived HIV risk.
These findings suggest that further guidance is needed for health care providers in prescribing PrEP to transgender women. Greater uptake and adherence are also needed for optimal effectiveness.</description><subject>Adult</subject><subject>Anti-HIV Agents - administration & dosage</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Cohort Studies</subject><subject>Criteria</subject><subject>Cross-Sectional Studies</subject><subject>Disease control</subject><subject>Female</subject><subject>Health Belief Model</subject><subject>Health care</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - prevention & control</subject><subject>HIV Infections - psychology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Indication</subject><subject>Male</subject><subject>Medication Adherence - psychology</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Middle Aged</subject><subject>Pre-Exposure Prophylaxis - methods</subject><subject>Pre-Exposure Prophylaxis - statistics & numerical data</subject><subject>Prevalence</subject><subject>Prophylaxis</subject><subject>Prospective Studies</subject><subject>Risk perception</subject><subject>Statistical analysis</subject><subject>Transgender persons</subject><subject>Transgender Persons - psychology</subject><subject>United States - epidemiology</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkdtuEzEQhlcIRA_wBghZ4oabLT6tnb2MokAjRSLQhl6uvPZs183GTm0vUd-Ex8VpykH1zdijf74Zz18U7wi-ILiWn75NFxf4v0MlFS-KU1JzXsrJhL_M94pWJSesOinOYrzDmAjO69fFCeOslpLT0-LXCoIG-xMMulz8QFN9P9pok_UOfbdxg5QzaOn3aL1LagPId2gV5is03Xp3ixSa-d6HdEhfB-XiLTgDAd34LTh0Y1N_VC-csVo9Qq1DqQc0VzFBcI_4Kz_mVH6snU15jqukEsQ3xatODRHePsXzYv15fj27LJdfvyxm02WpORWs7CiuoTVCVkIqZjShohWs5a3hkmjGW6l1p4zhlZ7QWhLKWy2lmHBBDDDZsfPi45G7C_5-hJiarY0ahkE58GNsaCVITXnF6yz98Ex658fg8nQNFaKuKGaMZhU_qnTwMQboml2wWxUeGoKbg3NNdq557lwue_8EH9stmL9Ff6z6x937Ie8uboZxD6HpQQ2pz7z8c8Z4STHNTTDB5QHN2G_B_KJ8</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Malone, Jowanna</creator><creator>Reisner, Sari L.</creator><creator>Cooney, Erin E.</creator><creator>Poteat, Tonia</creator><creator>Cannon, Christopher M.</creator><creator>Schneider, Jason S.</creator><creator>Radix, Asa</creator><creator>Mayer, Kenneth H.</creator><creator>Haw, J. 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Sonya</au><au>Althoff, Keri N.</au><au>Wawrzyniak, Andrew J.</au><au>Beyrer, Chris</au><au>Wirtz, Andrea L.</au><aucorp>American Cohort to Study HIV Acquisition Among Transgender Women (LITE) Study Group</aucorp><aucorp>For the American Cohort to Study HIV Acquisition Among Transgender Women (LITE) Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perceived HIV Acquisition Risk and Low Uptake of PrEP Among a Cohort of Transgender Women With PrEP Indication in the Eastern and Southern United States</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>88</volume><issue>1</issue><spage>10</spage><epage>18</epage><pages>10-18</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><abstract>Preexposure prophylaxis (PrEP) is effective in preventing HIV among adherent users. However, PrEP uptake among transgender women is low, and current prescribing guidelines from the Centers for Disease Control and Prevention (CDC) are not specific to transgender women. Self-perceived risk of HIV among those who are PrEP-indicated is not well understood.
This cross-sectional analysis included 1293 transgender women screened at baseline from March 2018 to May 2020 for a multisite, prospective cohort study. We compared the prevalence of PrEP indication using current CDC prescribing criteria versus transgender women-specific criteria developed by study investigators with community input. We identified factors associated with study-specific PrEP indication and factors associated with self-perceived low to no HIV risk among those who were PrEP-indicated. We also calculated descriptive statistics to depict the PrEP care continuum.
PrEP indication prevalence using transgender women-specific criteria was 47% (611), 155 more than who were identified using the CDC criteria. Eighty-three percent were aware of PrEP, among whom 38% had ever used PrEP. Among PrEP ever users, 63% were using PrEP at the time of the study. There were 66% of current PrEP users who reported 100% adherence within the previous 7 days. Among those who were PrEP-indicated, 13% were using and adherent to PrEP at the time of the study. More than half (55%) of PrEP-indicated participants had low or no self-perceived HIV risk.
These findings suggest that further guidance is needed for health care providers in prescribing PrEP to transgender women. Greater uptake and adherence are also needed for optimal effectiveness.</abstract><cop>United States</cop><pub>JAIDS Journal of Acquired Immune Deficiency Syndromes</pub><pmid>34397742</pmid><doi>10.1097/QAI.0000000000002726</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of acquired immune deficiency syndromes (1999), 2021-09, Vol.88 (1), p.10-18 |
| issn | 1525-4135 1944-7884 |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Free E- Journals |
| subjects | Adult Anti-HIV Agents - administration & dosage Anti-HIV Agents - therapeutic use Cohort Studies Criteria Cross-Sectional Studies Disease control Female Health Belief Model Health care Health Knowledge, Attitudes, Practice Health risks HIV HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - prevention & control HIV Infections - psychology Human immunodeficiency virus Humans Indication Male Medication Adherence - psychology Medication Adherence - statistics & numerical data Middle Aged Pre-Exposure Prophylaxis - methods Pre-Exposure Prophylaxis - statistics & numerical data Prevalence Prophylaxis Prospective Studies Risk perception Statistical analysis Transgender persons Transgender Persons - psychology United States - epidemiology |
| title | Perceived HIV Acquisition Risk and Low Uptake of PrEP Among a Cohort of Transgender Women With PrEP Indication in the Eastern and Southern United States |
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