Willingness to Use Pre-Exposure Prophylaxis (PrEP) for HIV Prevention and PrEP Implementation Preferences Among Transgender Women in Malaysia

Galka, Jonathan; Wang, Melinda; Azwa, Iskandar; Gibson, Britton A.; Lim, Sin How; Shrestha, Roman; Wickersham, Jeffrey A.

doi:10.1089/trgh.2020.0003

Cited by 13 publications

(27 citation statements)

References 28 publications

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“…PrEP awareness was low among TGW in LMICs (e.g., Vietnam 13.1%) compared to Upper-Middle Income Countries (Malaysia 20.2% and China 33.3%). 25,52,56 Among high-income countries, PrEP awareness was high among TGW ranging from 13.7% in the United States (San Francisco) in 2013 to 91.5% in the U.S in 2020. 51,55 At the individual level, we found that demographic and socioeconomic factors were associated with varying degrees of PrEP awareness.…”

Section: Resultsmentioning

confidence: 99%

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Barriers to uptake of PrEP across the continuum among transgender women: A global scoping review

et al. 2023

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Background Although preexposure prophylaxis (PrEP) has demonstrated high efficacy for HIV prevention, rates of PrEP uptake remain low among the transgender population, especially in transgender women (TGW). We conducted this scoping review to assess and characterize barriers to PrEP use along the PrEP care continuum among TGW. Methods We conducted this scoping review by searching studies in Embase, PubMed, Scopus, and Web of Science. Eligibility criteria included: reporting a PrEP related quantitative result among TGW; peer-reviewed and published in English between 2010-2021. Results Globally, high willingness (80%) to use PrEP was found, yet uptake and adherence (35.4%) were low. TGW experiencing hardship, including poverty, incarceration, and substance use, were associated with higher odds of PrEP awareness but lower odds of PrEP use. Structural and social barriers such as stigma, medical mistrust, and perceived racism can be important barriers for PrEP continuation. High social cohesion and hormone replacement therapy were associated with greater odds of awareness. In addition, our study confirmed prior research showing that PrEP does not lower feminizing hormone levels in TGW. Conclusions Significant demographic factors among TGW that are associated with PrEP engagement. It is imperative to focus on TGW as a population with independent needs, requiring specific PrEP care guidelines and tailored resource allocation, that fully considers individual-, provider-, and community/structural-level barriers and facilitators. The present review also indicates that combining PrEP care with GAHT or broader gender-affirmation care may facilitate PrEP use.

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Section: Resultsmentioning

confidence: 99%

“…Perceived behavioral control for using PrEP and perceived risk of HIV were also positively correlated with PrEP acceptability. 21,25,42,52,54…”

Section: Resultsmentioning

confidence: 99%

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Barriers to uptake of PrEP across the continuum among transgender women: A global scoping review

et al. 2023

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“…Those with previous knowledge believed that the treatment was only for MSM, seemingly focused on them. 30 Likewise, Galka et al 31 found that only 20% of the Malaysian transgender women that partake in the investigation had previous knowledge of PrEP. Contrastingly, the study made by Horvath et al 32 in the United States found high awareness amongst transgender youth; however, only one participant was using PrEP.…”

Section: Discussionmentioning

confidence: 94%

Adherence to Pre-exposure Prophylaxis intervention by transgender women: A systematic review

Quevedo

Pérez-Arizabaleta

Villegas-Trujillo³

et al. 2022

Preprint

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Background: The prevalence of HIV is higher in the transgender population. Recently, the preexposure prophylaxis (PrEP) intervention has been proven successful in reducing HIV acquisition in trials among men who have sex with men (MSM), and heterosexual couples. This research aims to investigate the adherence to PrEP by HIV-negative transgender women (TW). Methods: Were followed the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA Statement. Research in WoS, Ovid, Scopus, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases for studies that involved HIV-negative TW population and focused on their adherence to PrEP intervention and condom use after the treatment. Results: 11 studies were included. TW sample sizes were low in comparison to the total sample, which often included men who have sex with men (MSM) population. The participation and adherence to the intervention was low compared to MSM, and it was measured mainly by self-report (72.7%) or by Tenofovir-diphosphate (TFV-DP)/ Emtricitabine triphosphate (FTC-TP) dried blood spot (DBS) (45.5%). Conclusions: It is important to increase awareness and explain the effect of PrEP on feminizing hormone therapy at the beginning of the trials. Nevertheless, the low adherence may be affected by the interaction between drugs and the barriers faced to use the health services.

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“…Other than condoms, LGBTQ people were found to also utilize PrEP as an additional safe-sex protective measure (Bourne et al, 2017). There was a greater willingness to use PrEP when LGBTQ people were educated about its benefits and when the cost of the provision was affordable (Galka et al, 2020;Lim et al, 2013;Lim et al, 2017). However, societal stigma attached with PrEP usage (e.g., being perceived as often engaging in high-risk sexual behaviors) may deter LGBTQ people from using PrEP as a safe-sex measure (Bourne et al, 2017).…”

Section: Summary Of Evidencementioning

confidence: 99%

Current Research Involving LGBTQ People in Malaysia: A Scoping Review Informed by a Health Equity Lens

Tan

Lee

Cheong

2021

JPSS

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In Malaysia, lesbian, gay, bisexual, transgender, and queer people (collectively known as LGBTQ) are subjected to cisheterosexism that criminalizes, pathologizes, and marginalizes their identities. Given the relative cisheterosexist nature of Malaysian society, it is important to scrutinize the current trend of research studies that have recruited LGBTQ people as subjects. The present study comprises a scoping review of existing Malaysian studies involving LGBTQ people, as we set out to provide an overview of study characteristics, research methods, and literature gaps. Through systematic searches in the Malaysian Citation Index, PsycINFO, and PubMed databases, as well as additional hand searches, we included forty-four studies in this review. Our review noted many Malaysian LGBTQ studies explicitly focused on related topics of sexually transmitted infections (STIs) (41%), men who have sex with men (39%), trans women (30%), and people from Kuala Lumpur (25%). Our review also uncovered STI risks, living experiences in relation to cisheterosexism, and barriers to access safe-sex measures, healthcare, and social support among Malaysian LGBTQ people. Drawing from the health equity framework, we provided recommendations for future LGBTQ research in Malaysia to avoid utilizing a pathological lens that stands in contrast with LGBTQ-affirming approaches, as well as to engage LGBTQ members throughout all research phases.

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Willingness to Use Pre-Exposure Prophylaxis (PrEP) for HIV Prevention and PrEP Implementation Preferences Among Transgender Women in Malaysia

Cited by 13 publications

References 28 publications

Barriers to uptake of PrEP across the continuum among transgender women: A global scoping review

Barriers to uptake of PrEP across the continuum among transgender women: A global scoping review

Adherence to Pre-exposure Prophylaxis intervention by transgender women: A systematic review

Current Research Involving LGBTQ People in Malaysia: A Scoping Review Informed by a Health Equity Lens

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