Barriers and motivators to pre-exposure prophylaxis uptake among Black and Latina transgender women in Los Angeles: perspectives of current PrEP users

Nieto, Omar; Fehrenbacher, Anne E.; Cabral, Alejandra; Landrian, Amanda; Brooks, Ronald A.

doi:10.1080/09540121.2020.1769835

Cited by 28 publications

(53 citation statements)

References 27 publications

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“…[4][5][6][7][8] Existing research has predominantly focused on documenting facilitators and barriers to PrEP uptake among TGW/TFI, including PrEP awareness, attitudes, acceptability, and eligibility. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Few studies in the United States have included a substantial sample of TGW/TFI on PrEP, 8,10 and none have closely examined dynamics over time of real-world PrEP use (ie, in the absence of research incentive or intervention). As such, there has been little investigation of PrEP adherence patterns among TGW/TFI in the United States.…”

Section: Introductionmentioning

confidence: 99%

Brief Report: Transgender Women and Preexposure Prophylaxis Care: High Preexposure Prophylaxis Adherence in a Real-World Health Care Setting in New York City

Starbuck

Golub

Klein

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Transgender women and trans feminine individuals (TGW/TFI) are a high priority population for the provision of HIV preexposure prophylaxis (PrEP) care within the United States, but there is limited research that focuses specifically on PrEP adherence within this population.Setting: Observational study of patients prescribed PrEP at a community-based health center. Methods:We enrolled 100 TGW/TFI PrEP patients at a community health center during clinic visits. Adherence data were collected at 3 time points, using self-report surveys, patient interviews, and urine assays measuring tenofovir. Data were summarized descriptively. Results:The sample was diverse in age, race/ethnicity, and socioeconomic characteristics. Participants demonstrated strong PrEP adherence; at least 80% of the sample reported 90% or greater adherence at each time point. Concordance between self-report and urine assay was high. Among patients who reported taking PrEP within the past 48 hours, 82%-92% had detectable urine tenofovir. However, many patients reported PrEP stop periods of 4 or more days (28%-39% per time point).Conclusions: Our data highlight TGW/TFI's capacity to adhere to daily PrEP and sustain PrEP use over time. The concordance between patient self-report and urine TFV levels suggest that providers can trust patient reports of PrEP adherence behavior and support the use of adherence conversations in clinical settings, without the need for point of care biological monitoring. Findings also underscore the importance of continued attention to drivers of PrEP stops at the patient, clinic, and systems levels and the development of strategies that support sustained PrEP use.

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Section: Introductionmentioning

confidence: 99%

Brief Report: Transgender Women and Preexposure Prophylaxis Care: High Preexposure Prophylaxis Adherence in a Real-World Health Care Setting in New York City

Starbuck

Golub

Klein

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…The largest cluster of the physical health research was HIV‐focused (32) and examined pre‐exposure prophylaxis (PrEP) or HIV prevention/medication management (e.g., Nieto et al, 2020; Poteat et al, 2019), HIV Care (e.g., Rosen et al, 2019), or HIV risk and testing (e.g., Barrington et al, 2018; Palazzolo et al, 2016; Siembida et al, 2016). PrEP research addressed attitudes and knowledge (e.g., Barreras et al, 2019; Poteat et al, 2019), demographics of PrEP users (Holder et al, 2019; Nieto et al, 2020), reasons for not taking PrEP (Nieto et al, 2020; Poteat et al, 2019), barriers or access to PrEP (Holder et al, 2019), and interventions for delivering PrEP to this population (Callander et al, 2020). Researchers also explored willingness to have a vaccine or take a microbicide by TGNC POC (Poteat et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…Financial concerns ultimately formed the largest layer of structural barriers to better physical health (Loza et al, 2017; Palazzolo et al, 2016; Wilson et al, 2015). Lower income was associated with worse general health (Seelman et al, 2017), where individuals frequently had to choose between HIV care, hormonal therapies or body modifications, and/or meeting their basic living needs (Nieto et al, 2020; Poteat et al, 2019). Individuals without financial means may take it upon themselves to administer gender affirming healthcare (e.g., hormone therapies), despite being aware of the risks (Loza et al, 2017; Rhodes et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

The health and wellbeing of transgender and gender non‐conforming people of colour in the United States: A systematic literature search and review

Farvid

Vance

Klein

et al. 2021

Community & Applied Soc Psy

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Transgender and gender non‐conforming people (TGNC), individuals whose gender identity differs from the sex they were assigned at birth, experience unique stressors, discrimination, and barriers to health and wellbeing. TGNC People of Colour (POC) navigate the nexus of racism, cisgenderism (and often homophobia) in their daily lives, resulting in uniquely intersecting forms of discrimination, and pronounced disparities in their health and well‐being. In order to examine the current state of knowledge about the health and wellbeing of TGNC POC, we conducted a systematic search and review of peer‐reviewed journal articles published between 1 January 2010 and 1 May 2020 that focused on this population. A systematic search identified (3,575) papers, with 76 of those meeting full inclusion criteria. In our review, we were able to identify physical health and psychological wellbeing (which included resilience), as core clusters of research focused on TGNC POC. We identified specific factors that hindered physical and psychological health (what we call “push” factors) as well as those that promoted it (what we call “pull” factors). Leveraging these findings, we offer ways forward for best practice in clinical work and carrying out research with this population. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

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“…Studies have documented that many transgender individuals prioritize access to gender-affirming treatment over HIV prevention; codelivery of sexual health services alongside hormone and surgical treatment may therefore help improve uptake. 19,20 Provider knowledge around transgender health may also partly account for some of the gaps in PrEP care becuase many have reported feeling unprepared to address the health care needs of the population. 21,22 Universal collection of gender identity and sexual behavior data in routine care may help mitigate disparities, promote culturally affirming care, and allow for improved evaluation of the full PrEP continuum in transgender people, including identification of those with indications for PrEP.…”

Section: Discussionmentioning

confidence: 99%

HIV Pre-exposure Prophylaxis Continuum of Care Among Transgender Individuals in an Integrated Health care System

Hojilla

Hurley

Marcus

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Breakthrough infections with multiple lineages of SARS-CoV-2 variants reveals continued risk of severe disease in immunosuppressed patients. Viruses. 2021;13:13. 10. Self WH. Comparative effectiveness of moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) vaccines in Preventing COVID-19 hospitalizations among adults without immunocompromising conditions-United States, March-August 2021. MMWR Morb Mortal Wkly Rep. 2021:70. Available at: https://www. cdc.gov/mmwr/volumes/70/wr/mm7038e1. htm. Accessed September 18, 2021. 11. Office of the Commissioner. Coronavirus (COVID-19) update: FDA authorizes additional vaccine dose for certain immunocompromised individuals. 2021. Available at: https://www.fda.gov/news-events/pressannouncements/coronavirus-covid-19-updatefda-authorizes-additional-vaccine-dose-certain-immunocompromised. Accessed September 19, 2021. 12. Spinelli M, Peluso MJ, Lynch KL, et al. Post-mrna vaccination SARS-CoV-2 IGG concentrations and surrogate virus neutralization response compared by HIV status and type of vaccine: a matched casecontrol observational study. 2021. Available at: https://papers.ssrn.com/abstract=3909785. Accessed November 8, 2021. 13. Spinelli MA, Lynch KL, Yun C, et al. SARS-CoV-2 seroprevalence, and IgG concentration and pseudovirus neutralising antibody titres after infection, compared by HIV status: a matched case-control observational study.

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Barriers and motivators to pre-exposure prophylaxis uptake among Black and Latina transgender women in Los Angeles: perspectives of current PrEP users

Cited by 28 publications

References 27 publications

Brief Report: Transgender Women and Preexposure Prophylaxis Care: High Preexposure Prophylaxis Adherence in a Real-World Health Care Setting in New York City

Brief Report: Transgender Women and Preexposure Prophylaxis Care: High Preexposure Prophylaxis Adherence in a Real-World Health Care Setting in New York City

The health and wellbeing of transgender and gender non‐conforming people of colour in the United States: A systematic literature search and review

HIV Pre-exposure Prophylaxis Continuum of Care Among Transgender Individuals in an Integrated Health care System

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