Barriers and motivators to pre-exposure prophylaxis uptake among Black and Latina transgender women in Los Angeles: perspectives of current PrEP users

ABSTRACT

The purpose of this qualitative study was to identify barriers and motivators to PrEP uptake from the perspective of Black and Latina transgender women (TW) who are currently using PrEP to suggest intervention and outreach activities to increase PrEP uptake in this population. The Information-Motivation-Behavioral Skills Model guided the development of the semi-structured interview guide. A thematic analysis approach was used to analyze the data. Perceived barriers to PrEP uptake included structural and logistic barriers, language and cultural barriers to medical engagement, lack of transgender competent or gender-affirming care, and prioritizing hormone therapy over the use of PrEP. To increase PrEP uptake among BLTW, participants recommended disseminating PrEP information through a variety of methods, highlighting relationship and sexual health benefits of using PrEP, and developing effective patient-provider communication. Our findings highlight several ways to promote PrEP among BLTW. PrEP promotion should be integrated into gender-affirming care and supported by peer education and navigation services that reach BLTW in both clinic and community settings.

KEYWORDS:

• Black
• African American
• Latina
• transgender women
• pre-exposure prophylaxis

Acknowledgements

We thank the participants for graciously sharing their views and experiences for this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

The Institutional Review Board of the University of California, Los Angeles approved all study materials. All study procedures involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all human participants prior to the initiation of study procedures.

Additional information

Funding

This work was supported by the California Community Foundation under Grant # BA-17-136260 and the National Institute of Mental Health under Grant # R21MH107339, T32MH109205, and P30MH058107. Additional support was provided to the second author by NIH’s Fogarty International Center through a grant to the University of California Global Health Institute under Grant #D43TW009343. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the National Institutes of Health or any of the other funding sources.