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dc.contributor.author | Konda, Kelika A. | |
dc.contributor.author | Torres, Thiago S. | |
dc.contributor.author | Marino, Gabriela | |
dc.contributor.author | Ramos, Alessandra | |
dc.contributor.author | Moreira, Ronaldo, I | |
dc.contributor.author | Leite, Iuri C. | |
dc.contributor.author | Cunha, Marcelo | |
dc.contributor.author | Jalil, Emilia M. | |
dc.contributor.author | Hoagland, Brenda | |
dc.contributor.author | Guanira, Juan, V | |
dc.contributor.author | Benedetti, Marcos | |
dc.contributor.author | Pimenta, Cristina | |
dc.contributor.author | Vermandere, Heleen | |
dc.contributor.author | Bautista-Arredondo, Sergio | |
dc.contributor.author | Vega-Ramirez, Hamid | |
dc.contributor.author | Veloso, Valdilea G. | |
dc.contributor.author | Caceres Palacios, Carlos Fernando | |
dc.contributor.author | Grinsztejn, Beatriz | |
dc.contributor.author | ImPrEP Study Grp | |
dc.date.accessioned | 2022-11-15T23:04:42Z | |
dc.date.available | 2022-11-15T23:04:42Z | |
dc.date.issued | 2022 | |
dc.identifier.uri | https://hdl.handle.net/20.500.12866/12616 | |
dc.description.abstract | Introduction: The HIV epidemic continues to disproportionately impact Latin-American transgender women (TGW). We assessed factors associated with long-term pre-exposure prophylaxis (PrEP) engagement and adherence among TGW enrolled in the Implementation of PrEP (ImPrEP) study, the largest PrEP demonstration study in Latin America. Methods: HIV-negative TGW aged ≥18 years reporting 1+eligibility criteria in the 6 months prior to enrolment (e.g. sex partner known to be living with HIV, condomless anal sex [CAS], transactional sex or having a sexually transmitted infection [STI]) who could safely take PrEP were enrolled. Follow-up visits were conducted at 4 weeks and then quarterly. We conducted logistic regression to identify factors associated with long-term PrEP engagement (3+ follow-up visits in 52 weeks) and complete self-reported adherence (no missed pills in the past 30 days) during follow-up. For both outcomes, we constructed multivariable models controlling for country, socio-demographics, sexual behaviour, substance use, STIs and self-reported adherence at 4 weeks (long-term engagement outcome only). Results: From March 2018 to June 2021, ImPrEP screened 519 TGW, enrolled 494 (Brazil: 190, Mexico: 66 and Peru: 238) and followed them for 52 weeks. At baseline, 27.5% of TGW were aged 18–24 years, 67.8% were mixed-race and 31.6% had >secondary education. Most, 89.9% reported CAS, 61.9% had >10 sex partners and 71.9% reported transactional sex. HIV incidence was 1.82 cases per 100 person-years (95% confidence interval [CI]: 0.76–4.38). Almost half of TGW (48.6%) had long-term PrEP engagement, which was positively associated with reporting complete adherence at week 4 (aOR:2.94 [95%CI:1.88–4.63]) and was inversely associated with reporting CAS with unknown-HIV partner (aOR:0.52 [95%CI:0.34–0.81]), migration (aOR:0.54 [95%CI:0.34–0.84]), and being from Mexico (aOR:0.28 [95%CI:0.14–0.53]). Self-reported adherence was associated with TGW aged >34 (aOR:1.61 [95%CI:1.10–2.34]) compared to those aged 25–34 and those with >secondary education (aOR:1.55 [95%CI:1.10–2.19]) and was lower among TGW from Peru (aOR:0.29 [95%CI:0.21–0.41]) or reporting PrEP-related adverse effects (aOR:0.63 [95%CI:0.42–0.92]). Conclusions: Although TGW were willing to enrol in ImPrEP, long-term PrEP engagement and complete self-reported adherence were limited, and HIV incidence remained relatively high. A successful HIV prevention agenda should include trans-specific interventions supporting oral PrEP and exploring long-acting PrEP strategies for TGW. | en_US |
dc.language.iso | eng | |
dc.publisher | Wiley | |
dc.relation.ispartofseries | Journal of the International AIDS Society | |
dc.rights | info:eu-repo/semantics/restrictedAccess | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es | |
dc.subject | pre-exposure prophylaxis | en_US |
dc.subject | transgender persons | en_US |
dc.subject | HIV | en_US |
dc.subject | Latin America | en_US |
dc.subject | medication adherence | en_US |
dc.subject | public health | en_US |
dc.title | Factors associated with long-term HIV pre-exposure prophylaxis engagement and adherence among transgender women in Brazil, Mexico and Peru: results from the ImPrEP study | en_US |
dc.type | info:eu-repo/semantics/article | |
dc.identifier.doi | https://doi.org/10.1002/jia2.25974 | |
dc.relation.issn | 1758-2652 |
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