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Awareness and Willingness to use HIV Pre-exposure Prophylaxis (PrEP) Among Trans Women in China: A Community-Based Survey

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Abstract

China’s national guidelines call for increasing HIV pre-exposure prophylaxis (PrEP) use to reverse the epidemic in populations at highest risk. However, few data exist on PrEP awareness and willingness among trans women in China. Our research aim was to fill this data gap through a cross-sectional survey among trans women in Nanjing and Suzhou cities of Jiangsu province. Respondent-driven sampling (RDS) was used to recruit participants to gauge their awareness of and willingness to use PrEP. Logistic regression analysis was used to characterize associations with awareness of PrEP and willingness to use PrEP. Of 222 HIV-negative/unknown serostatus trans women, 33.3% were aware of PrEP and 49.1% were willing to use PrEP. PrEP awareness was associated with a university degree or above (adjusted odds ratio [AOR] 2.77, 95% CI 1.31–5.89) and not using alcohol with sex (AOR 2.02, 95% CI 1.00–4.09). Willingness to use PrEP was higher among trans women with one (AOR 3.56, 95% CI 1.68–7.54) or multiple sexual partners (AOR 2.53, 95% CI 1.24–5.15) compared to those with no partners. This study witnessed low awareness of PrEP, yet substantial willingness to use PrEP. Implementation research to identify ways to promote, scale up access, and assess effectiveness of PrEP for trans women is urgently needed in China.

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Acknowledgements

This research was supported by the National Institute on Minority and Health Disparities (R01MD010678).

Funding

This study was funded by the National Institute on Minority and Health Disparities (R01MD010678).

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Author notes

    Authors and Affiliations

    1. Xuzhou Central Hospital, Xuzhou, Jiangsu, China

      Li Yan

    2. University of California Berkeley, Berkeley, USA

      Zihan Yan

    3. Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 710, San Francisco, CA, 94102-6033, USA

      Erin Wilson, Sean Arayasirikul, Jessica Lin & Willi McFarland

    4. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA

      Erin Wilson & Willi McFarland

    5. Section of AIDS Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China

      Hongjing Yan

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    1. Li Yan
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    Correspondence to Willi McFarland.

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    Ethical Approval

    The study was reviewed and approved by the Institutional Review Boards of the University of California San Francisco and the Jiangsu provincial Center for Disease Control and Prevention. 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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    Written informed consent was obtained from all individual participants included in the study.

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    Li Yan and Zihan Yan contributed equally to this work.

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    Yan, L., Yan, Z., Wilson, E. et al. Awareness and Willingness to use HIV Pre-exposure Prophylaxis (PrEP) Among Trans Women in China: A Community-Based Survey. AIDS Behav 25, 866–874 (2021). https://doi.org/10.1007/s10461-020-03050-6

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