A cross-sectional analysis of psychosocial and structural barriers and facilitators associated with PrEP use among a sample of transgender women in Chicago, IL.
HIV
Pre-exposure prophylaxis
Transgender women
Journal
AIDS research and therapy
ISSN: 1742-6405
Titre abrégé: AIDS Res Ther
Pays: England
ID NLM: 101237921
Informations de publication
Date de publication:
21 04 2023
21 04 2023
Historique:
received:
24
10
2022
accepted:
03
04
2023
medline:
25
4
2023
pubmed:
22
4
2023
entrez:
21
04
2023
Statut:
epublish
Résumé
Expanding pre-exposure prophylaxis (PrEP) among transgender women in the United States is an important strategy to meet national HIV prevention goals, however self-reported use of PrEP is low in this group. This study reports the findings of a cross-sectional analysis of the relationship of barriers as well as facilitators to recent PrEP use among transgender women enrolled in an evaluation of the TransLife Care project (Chicago, Illinois), a structural intervention designed to meet basic needs. We computed multivariable prevalence ratios for barriers, facilitators and recent PrEP use, controlling for demographics. Findings suggest that psychosocial and structural barriers, including moderate/high alcohol use, stimulant use, and history of incarceration were all positively associated with recent PrEP use among urban transgender women. In addition, a psychosocial facilitator, gender affirmation, was positively associated with recent PrEP use, while, while collective self-esteem, a was negatively associated with it. Finally, common indications for PrEP have high sensitivity, but low specificity and predictive value for identifying those on PrEP. We conclude that despite a large gap in PrEP use among those with indications, individuals experiencing psychosocial and structural barriers are more likely to use PrEP, and facilitators, such as psychological sense of affirmed gender may support its use. N/A.
Sections du résumé
BACKGROUND
Expanding pre-exposure prophylaxis (PrEP) among transgender women in the United States is an important strategy to meet national HIV prevention goals, however self-reported use of PrEP is low in this group.
METHODS
This study reports the findings of a cross-sectional analysis of the relationship of barriers as well as facilitators to recent PrEP use among transgender women enrolled in an evaluation of the TransLife Care project (Chicago, Illinois), a structural intervention designed to meet basic needs. We computed multivariable prevalence ratios for barriers, facilitators and recent PrEP use, controlling for demographics.
RESULTS
Findings suggest that psychosocial and structural barriers, including moderate/high alcohol use, stimulant use, and history of incarceration were all positively associated with recent PrEP use among urban transgender women. In addition, a psychosocial facilitator, gender affirmation, was positively associated with recent PrEP use, while, while collective self-esteem, a was negatively associated with it. Finally, common indications for PrEP have high sensitivity, but low specificity and predictive value for identifying those on PrEP.
CONCLUSION
We conclude that despite a large gap in PrEP use among those with indications, individuals experiencing psychosocial and structural barriers are more likely to use PrEP, and facilitators, such as psychological sense of affirmed gender may support its use.
TRIAL REGISTRATION
N/A.
Identifiants
pubmed: 37085860
doi: 10.1186/s12981-023-00516-0
pii: 10.1186/s12981-023-00516-0
pmc: PMC10122350
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
24Subventions
Organisme : CDC HHS
ID : U01PS005140
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001422
Pays : United States
Informations de copyright
© 2023. The Author(s).
Références
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
AIDS Care. 2021 Feb;33(2):244-252
pubmed: 32449399
AIDS Behav. 2021 Jul;25(7):2301-2315
pubmed: 33515132
Am J Orthopsychiatry. 1998 Jul;68(3):361-71; discussion 372-5
pubmed: 9686289
J Acquir Immune Defic Syndr. 2021 Sep 1;88(1):10-18
pubmed: 34397742
JAMA. 2019 Mar 5;321(9):844-845
pubmed: 30730529
AIDS Behav. 2016 Jul;20(7):1470-7
pubmed: 26336946
Eval Program Plann. 2022 Feb;90:101998
pubmed: 34544606
Sex Roles. 2013 Jun 1;68(11-12):675-689
pubmed: 23729971
Int J Environ Res Public Health. 2021 Mar 23;18(6):
pubmed: 33806834
J Acquir Immune Defic Syndr. 2022 May 1;90(1):15-19
pubmed: 35013087
J Acquir Immune Defic Syndr. 2020 Aug 15;84(5):437-442
pubmed: 32692101
Am J Prev Med. 1994 Mar-Apr;10(2):77-84
pubmed: 8037935
Transgend Health. 2016 May 01;1(1):86-93
pubmed: 29159300
Glob Public Health. 2016 Aug-Sep;11(7-8):1060-75
pubmed: 26963756
J Int AIDS Soc. 2016 Oct 18;19(7(Suppl 6)):21105
pubmed: 27760683
AIDS Educ Prev. 2021 Aug;33(4):345-360
pubmed: 34370565
JAMA Pediatr. 2018 Oct 1;172(10):916-923
pubmed: 30105381