AIDS and Behavior

, Volume 22, Issue 11, pp 3649–3657 | Cite as

Acceptability of Antiretroviral Pre-exposure Prophylaxis from a Cohort of Sexually Experienced Young Transgender Women in Two U.S. Cities

  • Arjee J. Restar
  • Lisa Kuhns
  • Sari L. Reisner
  • Adedotun Ogunbajo
  • Robert Garofalo
  • Matthew J. MimiagaEmail author
Original Paper


Emtricitabine/tenofovir disoproxil fumarate as pre-exposure prophylaxis (PrEP) can prevent HIV infection among at-risk individuals, including young transgender women (YTW). We used baseline data from 230 HIV-uninfected YTW (ages 16–29 years) who were enrolled in Project LifeSkills during 2012–2015. We examined factors associated with perceived acceptability of PrEP use (mean score = 23.4, range 10.0–30.0). Participants were largely transgender women of color (67%) and had a mean age of 23 years (SD = 3.5). In an adjusted multiple linear regression model, PrEP interest (β = 3.7, 95% CI 2.2–5.2) and having a medical provider who meets their health needs (β = 2.9, 95% CI 1.3–4.4) was associated with higher PrEP acceptability scores, whereas younger age (21–25 vs 26–29 years) (β = –2.0, 95% CI − 3.6 to − 0.4) and reporting transactional sex in the past 4 months (β = − 1.5, 95% CI − 3.0 to − 0.1) was associated with lower PrEP acceptability scores (all p values < 0.05). Enhancing PrEP-related interventions by addressing the unique barriers to uptake among YTW of younger age or those with history of transactional sex could bolster PrEP acceptability for this population.


Pre-exposure prophylaxis Transgender women HIV prevention Young adults 


Emtricitabine/tenofovir disoproxil fumarate como profilaxis preexposición (PrEP) puede prevenir VIH en personas con alto riesgo, incluyendo mujeres jóvenes transgénero (YTW). Usamos datos de línea base de 230 YTW sin infección por VIH inscritas en Project LifeSkills para examinar las variables asociadas con aceptabilidad de PrEP (promedio=23.4, intervalo=10.0-30.0). Participantes eran mayormente mujeres transgénero de color (67%) con edad promedia de 23 años (DE=3.5). En un modelo de regresión lineal múltiple, interés en PrEP (β=3.7, 95% CI = 2.2–5.2) y tener un proveedor de atención medica que cumple con sus necesidades (β=2.9, 95% CI =1.3–4.4) era asociado con mayor aceptabilidad de PrEP, mientras que una edad menor (21-25 vs 26-29 años) (β=–2.0, 95% CI=-3.6–-0.4) y sexo transaccional en los últimos cuatro meses (β=–1.5, 95% CI =-3.0–-0.1) era asociado con menor aceptabilidad. Se necesitan intervenciones acerca de PrEP para YTW, sobre todo aquellas que han ejercido trabajo sexual, para aumentar la aceptabilidad de PrEP para esta población.



We would like to thank the participants for their participation, the members of the LifeSkills study teams in Boston and Chicago for their contribution in this study, and Alberto Edeza for translation of the abstract into Spanish. This project was supported by award number R01MH094323 from the National Institute of Mental Health (NIMH; PIs: Drs. Garofalo and Mimiaga). Ms. Arjee Restar is supported by a National Institute of General Medical Sciences training grant (R25GM083270) and the Robert Wood Johnson Foundation Health Policy Research Scholars. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health, the National Institutes of Health or the Robert Wood Johnson Foundation.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceUSA
  2. 2.Center for Health Equity ResearchBrown UniversityProvidenceUSA
  3. 3.Division of Adolescent MedicineAnn & Robert H. Lurie Children’s HospitalChicagoUSA
  4. 4.Department of Pediatrics, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  5. 5.Division of General PediatricsBoston Children’s Hospital/Harvard University Medical SchoolBostonUSA
  6. 6.Department of EpidemiologyHarvard T. H. Chan School of Public HealthBostonUSA
  7. 7.The Fenway Institute, Fenway HealthBostonUSA
  8. 8.Department of EpidemiologyBrown University School of Public HealthProvidenceUSA
  9. 9.Departments of Behavioral & Social Health Sciences and Epidemiology, Center for Health Equity ResearchBrown UniversityProvidenceUSA

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