Acceptability of Daily Use of Free Oral Pre-exposure Prophylaxis (PrEP) Among Transgender Women Sex Workers in Shenyang, China
- 306 Downloads
This study investigated the acceptability of daily use of free oral pre-exposure prophylaxis (PrEP) and associated factors among transgender women sex workers in Shenyang, China, following a briefing on PrEP. A total of 183 HIV negative or sero-status unknown participants completed the cross-sectional survey. The prevalence of acceptability of daily use of free oral PrEP was 61.2%. Adjusting for education level and monthly income, variables on negative attitudes toward PrEP (i.e., having concerns about the side-effects of PrEP) [Adjusted odds ratios (AOR): 0.26], perceived subjective norms (i.e., perceiving support from male partners to take PrEP) (AOR: 2.08), and perceived behavioral control (e.g., perceiving complete control over using PrEP) (AOR: 2.10–16.72) were significantly associated with acceptability of daily use of free oral PrEP. In addition, experiencing violence during sex work, perceived risk of contracting HIV from clients and probable anxiety were also significant. Future PrEP promotion campaigns should consider these factors.
KeywordsAcceptability Pre-exposure prophylaxis Transgender women sex workers Theory of planned behavior China
Adjusted odds ratios
Condomless receptive anal intercourse
Exploratory factor analysis
Female sex workers
Human immunodeficiency virus
Men who have sex with men
Male sex workers
Non-regular sex partner
Univariate odds ratios
Multivariate odds ratios
Regular sex partner
Sexually transmitted diseases
Tenofovir disoproxil fumarate
Theory of planned behavior
World Health Organization
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
Research Involving Human Participants
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Survey and Behavioural Research Ethics Committee, the Chinese University of Hong Kong and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 2.Center for AIDS Prevention Studies. What are the prevention needs of male-to-female transgender persons (MTFs)? San Francisco, CA: University of California, San Francisco. 2001. http://www.caps.ucsf.edu/pubs/FS/MTF.php.
- 13.Goswami P, Rachakulla HK, Ramakrishnan L, Mathew S, Ramanathan S, George B, et al. An assessment of a large-scale HIV prevention programme for high-risk men who have sex with men and transgenders in Andhra Pradesh, India: using data from routine programme monitoring and repeated cross-sectional surveys. BMJ Open. 2013;3(4):e002183.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Subramanian T, Ramakrishnan L, Aridoss S, Goswami P, Kanguswami B, Shajan M, et al. Increasing condom use and declining STI prevalence in high-risk MSM and TGs: evaluation of a large-scale prevention program in Tamil Nadu, India. BMC Public Health. 2013;13:857.CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Baeten J, Celum C. Antiretroviral pre-exposure prophylaxis for HIV-1 prevention among heterosexual African men and women: the Partners PrEP Study. In: 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention. Rome. 2011.Google Scholar
- 19.Choopanya K, Martin M, Suntharasamai P, Sangkum U, Mock PA, Leethochawalit M, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381(9883):2083–90.CrossRefPubMedGoogle Scholar
- 20.Gomez GB, Borquez A, Caceres CF, Segura ER, Grant RM, Garnett GP, et al. The potential impact of pre-exposure prophylaxis for HIV prevention among men who have sex with men and transwomen in Lima, Peru: a mathematical modelling study. PLoS Med. 2012;9(10):e1001323.CrossRefPubMedPubMedCentralGoogle Scholar
- 21.World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. 2014. http://www.who.int/hiv/pub/guidelines/keypopulations/en/.
- 23.Hoagland B, De Boni RB, Moreira RI, Madruga JV, Kallas EG, Goulart SP, et al. Awareness and willingness to use pre-exposure prophylaxis (PrEP) among men who have sex with men and transgender women in Brazil. AIDS Behav. 2016.Google Scholar
- 24.Oldenburg CE, Le B, Toan T, Thien DD, Huyen HT, Friedman MR, et al. HIV pre-exposure prophylaxis indication and readiness among HIV-uninfected transgender women in Ho Chi Minh City, Vietnam. AIDS Behav. 2016.Google Scholar
- 26.Golub SA, Gamarel KE, Rendina HJ, Surace A, Lelutiu-Weinberger CL. From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care STDs. 2013;27(4):248–54.CrossRefPubMedPubMedCentralGoogle Scholar
- 44.Wang Z, Feng T, Lau JT. Needs assessment and theory-based promotion of voluntary medical male circumcision (VMMC) among male sexually transmitted diseases patients (MSTDP) in China. AIDS Behav. 2015.Google Scholar
- 50.Guidance for the use of pre-exposure prophylaxis (PrEP) to prevent HIV transmission. 2016. http://www.hivguidelines.org/wp-content/uploads/2016/02/PrEP-Guidance_10-14-15.pdf.
- 53.Wilde GJS. Target risk: dealing with danger of death, disease, and damage in everday decisions. Ontario: PDE Publications; 1994.Google Scholar