Improved PrEP Awareness and Use among Trans Women in San Francisco, California

Abstract

Transgender women face a serious risk of HIV infection. Despite this, there is limited knowledge and use of Pre-exposure prophylaxis (PrEP). We measured the continuity of prevention across services in the PrEP cascade and correlates of PrEP use among trans women in San Francisco enrolled in the 2019/20 National HIV Behavioral Surveillance Study. Knowledge and use of PrEP among trans women in San Francisco increased in recent years; almost all (94.0%) had heard about PrEP, 64.7% had discussed PrEP with a healthcare provider, and 44.8% had taken PrEP in the past 12 months. PrEP use was associated with participation in a PrEP demonstration project (aOR = 31.44, p = 0.001) and condomless receptive anal intercourse (aOR = 3.63, p = 0.024). Injection drug use was negatively associated (aOR = 0.19, p = 0.014). Efforts are needed to combat the gender-based stigma and discrimination faced by trans women, which can result in avoidance and mistrust of the medical system.

Scaling up preexposure prophylaxis to maximize HIV prevention impact

“…In San Francisco, by 2019, PrEP coverage among eligible people was estimated to be 85% [11]. PrEP use was somewhat lower in transgender women (45%), but levels of use were increasing [12]. In Australia, PrEP roll-out began later, in 2016, but stands out for its rapid pace.…”

HIV prevalence, engagement in care, and risk behavior among trans women, San Francisco: Evidence of recent successes and remaining challenges

“…4,6 Preexposure prophylaxis (PrEP) awareness and use among trans women, while lower than among men who have sex with men (MSM), has increased in San Francisco. 4,7 PrEP awareness among HIV negative trans women was 79% in early 2018 and 94% in early 2020. 6,7 An important mechanism to assess the progression of care and treatment for HIV infection is the HIV care continuum or cascade, a simple framework that illustrates access to and retention in care within different stages.…”

“…4,7 PrEP awareness among HIV negative trans women was 79% in early 2018 and 94% in early 2020. 6,7 An important mechanism to assess the progression of care and treatment for HIV infection is the HIV care continuum or cascade, a simple framework that illustrates access to and retention in care within different stages. 8,9,10 The HIV care cascade aims to determine priority endpoints for interventions to reach, engage and retain trans women in HIV testing and treatment.…”

“… 4 , 6 Pre-exposure prophylaxis (PrEP) awareness and use among trans women, while lower than among men who have sex with men (MSM), has increased in San Francisco. 4 , 7 PrEP awareness among HIV negative trans women was 79% in early 2018 and 94% in early 2020. 6 , 7 …”

“… 4 , 7 PrEP awareness among HIV negative trans women was 79% in early 2018 and 94% in early 2020. 6 , 7 …”