Black transgender women (BTW) in the United States experience disproportionate rates of HIV despite biomedical prevention interventions such as pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP). Using a sample of 490 BTW collected from 2014 to 2017, bivariate, multivariable, and multinomial analyses were conducted to determine factors associated with awareness and use of PrEP and nPEP. BTW living with HIV were more aware of PrEP than HIV-negative BTW. Structural, demographic, and trans-specific factors (e.g., experiences of homelessness, violence, and current hormone use) related to HIV risk were associated with PrEP and nPEP awareness. PrEP use was associated with behavioral HIV risks (e.g., STI diagnosis, having an HIV-positive partner, and needle-sharing) and may demonstrate risk recognition among BTW. Knowing someone using PrEP was significantly positively associated with PrEP use. Development of guidelines for PrEP and nPEP use for BTW should leverage the strengths of guidelines for other populations, while also acknowledging the unique risks for this population.
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We thank the Center for Black Equity and local Black Pride organizations for partnering with us to implement POWER, the community based organizations who performed onsite HIV testing on the study’s behalf, the thousands of study participants who volunteered their time to contribute to this research, and members of the POWER Study Team who made data collection possible. The local Black Pride organizations are as follows: D.C. Black Pride, Detroit’s Hotter than July, Houston Splash, In the Life Atlanta, Memphis Black Pride, and Philadelphia Black Pride. The community based organizations who performed onsite HIV testing are as follows: Atlanta: AID Atlanta, AIDS Health Care Foundation, NAESM; Detroit: Community Health Awareness Group, Horizons Project, Unified; Houston: Avenue 360, Houston AIDS Foundation, Positive Efforts; Memphis: Friends for Life; Philadelphia: Access Matters, Philadelphia FIGHT; Washington, D.C.: Us Helping Us.
Data from this study came from the National Institute for Nursing Research Grant R01NR013865. Support for this analysis was partially supported by NIMH training Grant 5-T32MH094174-09.
Conflicts of Interest
There are no conflicts of interest to report for any of this paper’s contributing authors. This original, unpublished manuscript has not been submitted for review to any other journal and has been read and approved by all co-authors.
All study procedures and consent documents were approved by the University of Pittsburgh Institutional Review Board.
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Chandler, C.J., Creasy, S.L., Adams, B.J. et al. Characterizing Biomedical HIV Prevention Awareness and Use Among Black Transgender Women in the United States. AIDS Behav 25, 2929–2940 (2021). https://doi.org/10.1007/s10461-021-03189-w