Correlates of PrEP Indication in a Multi-Site Cohort of Young HIV-Uninfected Transgender Women.

Abstract

Transgender women are at high risk of HIV infection, with younger transgender women (YTW) particularly vulnerable. Pre-Exposure Prophylaxis (PrEP) has shown efficacy in reducing HIV acquisition, but little is known about PrEP indication or initiation among YTW. Baseline data from 180 YTW age 18-29years enrolled in Project LifeSkills, an on-going HIV prevention intervention for YTW, were analyzed to examine factors associated with PrEP indication. The sample (mean age=23.4, SD=3.2) was comprised largely of women of color (69%) and of low socioeconomic status (71% unemployed). Overall, 62% met criteria for PrEP indication, but only 5% reported ever taking PrEP. Factors associated with increased odds of PrEP indication were: PrEP interest (aOR 3.24; 95% CI 1.44, 7.33), number of recent anal sex partners (aOR 1.23; 95% CI 1.04, 1.46), and lower collective self-esteem scores (aOR 0.67; 95% CI 0.47, 0.94). Despite high levels of PrEP indication, there remain low levels of PrEP awareness and uptake among YTW.