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Use of HIV Self-Testing Kits to Screen Clients Among Transgender Female Sex Workers in New York and Puerto Rico

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Abstract

Transgender female sex workers (TFSW) are highly affected by HIV, with a global prevalence of 27%. HIV self-testing (HIVST) to screen sexual partners has helped men who have sex with men and female sex workers make informed sexual decisions and avoid HIV exposure. This is the first report on TFSW’s experiences screening clients using HIVST. Ten TFSW were each given ten HIVST kits and returned after 3 months to complete an online questionnaire and undergo an interview. Eight of them reported using HIVST with potential partners. Among fifty potential partners who were asked in person to test, 42 (84%) were clients. Thirty-four out of fifty (68%) accepted and 16 (32%) refused. Very few violent incidents occurred, and participants felt empowered by offering HIVST to others. Nevertheless, HIVST market cost was prohibitive for future use. HIVST use with clients could be feasible for TFSW if the cost were lowered or subsidized.

Resumen

Globalmente, las trabajadoras sexuales transgéneros (TSTG) tienen un 27% de prevalencia VIH. El uso del autotest para VIH (HIVST) para examinar a parejas sexuales ha ayudado a los hombres que tienen relaciones sexuales con hombres y a las mujeres trabajadoras sexuales a tomar decisiones informadas sobre las relaciones sexuales y evitar exponerse al VIH. Éste es el primer reporte sobre las experiencias que tuvieron TSTG usando el HIVST para examinar a sus clientes. Diez TSTG recibieron diez equipos de prueba de HIVST cada una y regresaron después de tres meses para completar un cuestionario por Internet y ser entrevistadas. Ocho de ellas reportaron haber usado HIVST con posibles compañeros sexuales. De los cincuenta posibles compañeros sexuales que fueron invitados en persona a usar la prueba, 42 (84%) eran clientes. Treinta y cuatro de los cincuenta (68%) aceptaron usar la prueba y 16 (32%) se negaron. Hubo muy pocos incidentes de violencia, y las participantes se sintieron empoderadas al ofrecer HIVST a los demás. Sin embargo, las TSTG encontraron que el precio comercial del HIVST es una barrera para el uso futuro. El uso del HIVST con clientes podría ser factible para las TSTG si el costo fuera más bajo o fuera subvencionado.

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Acknowledgements

The authors wish to thank the participants who shared their time and thoughts about using HIVST kits with clients. This project was supported by a grant from the NICHD (R01-HD076636; PI: Carballo-Diéguez, PhD). This work was also supported by a Center Grant from the NIMH to the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University (P30-MH43520; PI: Remien, PhD). William Brown III was supported by the National Library of Medicine (NLM) [grant numbers R01-LM012355 PI: Schillinger, T15-LM007079 PI: Hripcsak, R01-LM013045 PI: Lyles], the National Institute on Minority Health and Health Disparities (NIMHD) [grant number P60-MD006902 PI: Bibbins-Domingo], the Agency for Healthcare Research and Quality (AHRQ) [grant number K12-HS026383], and the National Center for Advancing Translational Sciences (NCATS) of the NIH [UCSF-CTSI grant number KL2-TR001870] during various stages of the research and/or preparation of the article. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Funding

This study was funded by a grant from the NICHD (R01-HD076636; PI: Carballo-Diéguez, PhD).

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Authors and Affiliations

  1. Division of Gender, Sexuality and Health, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA

    Rebecca Giguere, Javier Lopez-Rios, Timothy Frasca, Cody Lentz, Iván C. Balán, Curtis Dolezal, Christine Tagliaferri Rael, William Brown III, Alan Z. Sheinfil & Alex Carballo-Diéguez

  2. Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA

    Javier Lopez-Rios

  3. Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA

    William Brown III

  4. Department of Medicine, Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, CA, USA

    William Brown III

  5. Bakar Computational Health Science Institute, University of California San Francisco, San Francisco, CA, USA

    William Brown III

  6. Department of Psychology, Syracuse University, Syracuse, NY, USA

    Alan Z. Sheinfil

  7. Department of Pediatrics, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico

    Catherine Cruz Torres, Raynier Crespo & Irma Febo

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  1. Rebecca Giguere
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Correspondence to Rebecca Giguere.

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All procedures performed in studies involving human participants were 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.

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Giguere, R., Lopez-Rios, J., Frasca, T. et al. Use of HIV Self-Testing Kits to Screen Clients Among Transgender Female Sex Workers in New York and Puerto Rico. AIDS Behav 24, 506–515 (2020). https://doi.org/10.1007/s10461-019-02730-2

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