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HIV Risk Perception and Pre-Exposure Prophylaxis (PrEP) Awareness Among Transgender Women from Mexico

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Abstract

This study aimed to identify factors associated with HIV risk perception among Mexican transgender women (TGW). This cross-sectional survey was conducted online and at a public HIV clinic in Mexico City. Participants were ≥ 18 years old, self-identified as TGW, and reported not living with HIV. They answered questions on sexual behavior, HIV risk perception, and pre-exposure prophylaxis (PrEP) awareness. We performed a multivariate logistic regression to accomplish the study’s objective. One hundred ninety-one TGW completed the survey. High HIV risk perception was associated with > 5 sexual partners, condomless receptive anal sex, sex with a male partner(s) of unknown HIV status, and PrEP awareness. Although most TGW reported low HIV risk perception, over half had risk sexual behavior, reflecting inaccurate risk assessment. Future interventions to improve accurate risk perception among TGW should promote HIV transmission and prevention knowledge and increase PrEP awareness and uptake.

Resumen

Este estudio tuvo como objetivo identificar los factores asociados con la percepción de riesgo al VIH entre las mujeres trans (MT) mexicanas. El reclutamiento de esta encuesta transversal se realizó en línea y en una clínica pública de VIH en la Ciudad de México. Las participantes tenían ≥ 18 años, se autoidentificaron como MT y reportaron no vivir con VIH. Respondieron preguntas sobre su comportamiento sexual, percepción del riesgo al VIH y conocimiento de la profilaxis preexposición (PrEP). Se realizó un análisis de regresión logística multivariado para cumplir con el objetivo del estudio. Ciento noventa y uno participantes completaron la encuesta. La percepción de alto riesgo al VIH se asoció con > 5 parejas sexuales, sexo anal receptivo sin condón, sexo con una pareja masculina de estado serológico desconocido y conocimiento de la PrEP. Aunque la mayoría de las MT informaron baja percepción del riesgo al VIH, más de la mitad reportaron conductas sexuales de riesgo, lo que refleja una evaluación de riesgo inexacta. Futuras intervenciones para mejorar la percepción precisa del riesgo entre las MT deben centrarse en promover el conocimiento de transmisión y la prevención del VIH, así como aumentar el conocimiento y la aceptación de la PrEP.

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Data Availability

The authors ensure that all data reflects published statements. The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We want to thank the Ministry of Health of Mexico and all the participants who helped with this survey. We are also grateful to Clinica Especializada Condesa and the staff: Erica González, MD, and María Guadalupe Martínez, RN, who facilitated contact with the participants and encouraged them to participate; and research assistant Lorena Hernández-Cariño. Also, thanks to UNFPA Mexico for coordinating the allocation of funds in Mexico to undertake this research.

Funding

This project was made possible by Unitaid’s funding and support. Unitaid is a hosted partnership of the WHO. Unitaid expedites access to innovative health products and lays the foundations for their scale-up by countries and partners. Thiago S. Torres acknowledge funding from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Fundação de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ).

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Authors and Affiliations

  1. National Institute of Psychiatry Ramon de la Fuente Muñiz, Col. San Lorenzo Huipulco Alc. Tlalpan, 14370, Mexico City, Mexico

    Centli Guillen-Diaz-Barriga, Dulce Diaz-Sosa, Rebeca Robles-Garcia & Hamid Vega-Ramirez

  2. Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, Brazil

    Thiago S. Torres, Brenda Hoagland, Marcos Benedetti, Beatriz Grinsztejn & Valdilea G. Veloso

  3. Universidad Peruana Cayetano Heredia, Lima, Peru

    Kelika A. Konda & Carlos F. Caceres

  4. Ministry of Health, Brasilia, DF, Brazil

    Cristina Pimenta

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  1. Centli Guillen-Diaz-Barriga
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Contributions

HVR, TST, and KAK developed the survey and designed the study. CGDB and DDS conducted the fieldwork in Mexico. CGDB, HVR, and DDS conducted the data analysis and wrote the manuscript. TST, KAK, and RRG reviewed the results and the draft. BH, MB, CP, BG, CFC, and VGV reviewed, contributed intellectually, and approved the final version.

Corresponding author

Correspondence to Hamid Vega-Ramirez.

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Conflict of Interest

The authors declare no conflict of interest. Kelika A. Konda reports employment at Universidad Peruana Cayetano Heredia and University of California, Los Angeles.

Ethics Approval

This study was approved by the Research Ethics Committee of the National Institute of Psychiatry Ramón de la Fuente Muñiz (#CEI/C/038/2018) of Mexico City.

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Informed consent was obtained from all individual participants included in the study.

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Guillen-Diaz-Barriga, C., Diaz-Sosa, D., Torres, T.S. et al. HIV Risk Perception and Pre-Exposure Prophylaxis (PrEP) Awareness Among Transgender Women from Mexico. AIDS Behav 27, 992–1002 (2023). https://doi.org/10.1007/s10461-022-03836-w

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