HIV pre-exposure prophylaxis (PrEP) awareness and acceptability among trans women: a review

ABSTRACT

Transgender (trans) women are disproportionally burdened by the HIV epidemic due to complex structural, psychosocial and biological factors. HIV pre-exposure prophylaxis (PrEP) is a biomedical prevention approach for people at substantial risk of acquiring HIV. This literature review assessed awareness, willingness to use, and barriers and facilitators for PrEP acceptability among trans women. A search was conducted through five databases and included studies with primary data and disaggregate results for trans women. Of 255 retrieved citations, 17 met the inclusion criteria and were included. Low to moderate knowledge about PrEP was observed among studies. However, willingness to use PrEP was predominantly high. Frequent barriers to PrEP acceptability included concerns about side effects, cost, hormone therapy, adherence, PrEP-related stigma and interaction with healthcare workers. Facilitators included perceived reduction of HIV risk, fear of HIV/AIDS and reduced dependence on partners. Findings suggest elevated interest in PrEP and highlight important barriers and facilitators that should be specifically addressed to optimize PrEP uptake and use among this highly vulnerable population.

KEYWORDS:

• Pre-exposure prophylaxis
• PrEP
• transgender women
• HIV prevention
• awareness
• acceptability

Acknowledgements

This study did not receive any funding. The authors acknowledge the work of the research teams whose publications were included in this review, as well as the participation of all trans women involved in those studies.

Disclosure statement

No potential conflict of interest was reported by the authors.

Human and animal participants

This article does not contain any studies with human participants or animals performed by the authors.

ORCID

Nathália Pacífico de Carvalho http://orcid.org/0000-0002-4142-4411

Cássia Cristina Pinto Mendicino http://orcid.org/0000-0002-1627-292X

Raissa Carolina Fonseca Cândido http://orcid.org/0000-0002-5353-8125

Denyr Jeferson Dutra Alecrim http://orcid.org/0000-0003-0913-418X

Cristiane Aparecida Menezes de Pádua http://orcid.org/0000-0001-7083-3188