Young Transgender Women’s Attitudes Toward HIV Pre-exposure Prophylaxis

In Journal of Adolescent Health, Sarah Wood and colleagues, including Nadia Dowshen, seek to understand young transgender women’s (YTW) attitudes toward HIV pre-exposure prophylaxis (PrEP) in order to improve PrEP uptake in this population. Previous studies have shown that, despite a significantly higher risk for HIV amongst YTW, awareness of and access to PrEP remains disproportionately low. The investigators conducted qualitative interviews focusing on participants’ knowledge, attitudes, and experience with PrEP. Sixty-four percent of participants reported knowledge of PrEP. However, those who did not have previous knowledge of PrEP expressed surprise and frustration that they had never heard of it, particularly from health care providers. Participants expressed overwhelmingly positive attitudes towards PrEP’s effectiveness for preventing HIV, as well as its accessibility through community programs. Notably, both HIV-positive and negative participants felt that PrEP has emotional and relationship benefits, extending beyond HIV prevention alone. However, several barriers to PrEP access in the YTW community were also noted, including cost, PrEP-related stigma, side effects, and adherence challenges. The authors developed a theoretical model based on these results, noting that PrEP awareness as well as extended non-clinical benefits are key determinants in facilitating PrEP uptake.