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Characterizing Biomedical HIV Prevention Awareness and Use Among Black Transgender Women in the United States

AIDS and Behavior volume 25, pages 2929–2940 (2021)Cite this article

Abstract

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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Acknowledgements

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.

Funding

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.

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Authors and Affiliations

  1. Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Cristian J. Chandler, Brian J. Adams & M. Reuel Friedman

  2. Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Stephanie L. Creasy, Leigh A. Bukowski & James E. Egan

  3. Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Stephanie L. Creasy, Brian J. Adams, Leigh A. Bukowski, James E. Egan, M. Reuel Friedman, Ronald D. Stall & Darren L. Whitfield

  4. Institute for Collaboration On Health, Intervention, and Policy, University of Connecticut, 2006 Hillside Road, Storrs, CT, 06269-1248, USA

    Lisa A. Eaton

  5. Center for Interdisciplinary Research On AIDS, Yale University, 135 College Street, New Haven, CT, 06510, USA

    Cristian J. Chandler

  6. School of Social Work, University of Pittsburgh, 230 Cathedral of Learning, Pittsburgh, PA, 15260, USA

    Darren L. Whitfield

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  1. Cristian J. Chandler
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  2. Stephanie L. Creasy
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  3. Brian J. Adams
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  4. Lisa A. Eaton
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Contributions

CJC, RDS, SLC, DLW and LAB conceptualized the topic; CJC led writing and SLC, BJA, LAE and DLW contributed to drafting of sections; JEE provided writing about PrEP; LAB completed initial data cleaning and drafted part of the analysis; CJC, LAE, MRF drafted part of the analysis and results; and CJC conducted analysis and revised analysis. All authors contributed to writing and review of the manuscript and all agreed to manuscript submission.

Corresponding author

Correspondence to Cristian J. Chandler.

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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.

Ethical Approval

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

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