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Exploring the Association Between Gender Affirmation and PrEP use Among Transgender Women in New York City

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Abstract

Black and Hispanic/Latina transgender women are inequitably impacted by HIV; yet gaps in PrEP use exist. Among a sample of mostly Black and Hispanic/Latina transgender women in New York City, we aim to examine whether PrEP use was associated with gender affirmation and the use of gender-affirming health services. We found that PrEP use was more prevalent among those who used hormone therapy and those who had a provider they were comfortable speaking to about gender-related issues. In separate models, these associations were attenuated when adjusting for race/ethnicity, with those who use hormones being marginally more likely to report PrEP use and with Hispanic/Latina transgender women being more likely to have used PrEP, compared to Black transgender women. We found evidence of a potential association between medical gender affirmation and PrEP use. More research is needed to explore the social and structural contexts that are influenced by race/ethnicity that may serve to prevent PrEP uptake.

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Acknowledgements

This study was funded by CDC grant 1U62PS005086. We thank all our participants and staff (Aneesha Andrews, Charm Jones, Alisha King, Pablo Martinez, Jaime Santana-Rivera, Sofia Song, and Ash Tebar) as well as the members of our Collaborative Board (Carrie Davis, MSW; Octavia Lewis, MPA; Monique Mackey, and Nala Toussaint). We thank Destination Tomorrow and the OASIS Wellness Center of the Latino Commission on AIDS for providing space to conduct data collection activities. We also thank the MAC AIDS Foundation for a generous donation.

Funding

This study was funded by CDC grant 1U62PS005086.

Conflicts of Interests:

The authors have no competing interests to declare that are relevant to the content of this article.

Ethics Approval:

The study was approved by the Institutional Review Board of the New York City Department of Health and Mental Hygiene.

Consent to Participate:

All participate provided informed consent to participate.

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Not applicable.

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Authors and Affiliations

  1. Bureau of Hepatitis, HIV, and STI, New York City Department of Health and Mental Hygiene, 42-09 28th Street, CN-44, 11101, Queens, NY, USA

    Alexis V. Rivera & Sarah L. Braunstein

  2. Bureau of Division Management and Systems Coordination, New York City Department of Health and Mental Hygiene, Queens, NY, USA

    Jasmine M. Lopez

Authors
  1. Alexis V. Rivera
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  3. Sarah L. Braunstein
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Contributions

All authors contributed to study implementation and overseeing data collection. The analysis was performed by Alexis Rivera. The first draft of the manuscript was written by Alexis Rivera and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Gender affirmation and PrEP use.

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Correspondence to Alexis V. Rivera.

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Rivera, A.V., Lopez, J.M. & Braunstein, S.L. Exploring the Association Between Gender Affirmation and PrEP use Among Transgender Women in New York City. AIDS Behav 27, 1523–1530 (2023). https://doi.org/10.1007/s10461-022-03944-7

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