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Factors associated with long-term HIV pre-exposure prophylaxisengagement and adherence among transgender women in Brazil,Mexico and Peru: results from the ImPrEP study

dc.creatorKonda, Kelika A.es_ES
dc.creatorTorres, Thiago S.es_ES
dc.creatorMariño, Gabrielaes_ES
dc.creatorRamos, Alessandraes_ES
dc.creatorMoreira, Ronaldo I.es_ES
dc.creatorLeite, Iuri C.es_ES
dc.creatorCunha, Marceloes_ES
dc.creatorJalil, Emilia M.es_ES
dc.creatorHoagland, Brendaes_ES
dc.creatorGuanira, Juan V.es_ES
dc.creatorBenedetti, Marcoses_ES
dc.creatorPimenta, Cristinaes_ES
dc.creatorVermandere, Heleenes_ES
dc.creatorBautista-Arredondo, Sergioes_ES
dc.creatorVega-Ramirez, Hamides_ES
dc.creatorVeloso, Valdilea G.es_ES
dc.creatorCaceres, Carlos F.es_ES
dc.creatorGrinsztejn, Beatrizes_ES
dc.creatorImPrEP Study Groupes_ES
dc.date2022
dc.date.accessioned2024-10-04T20:09:51Z
dc.date.available2024-10-04T20:09:51Z
dc.date.issued2022
dc.identifier2024es_ES
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/8070
dc.identifier.urihttps://doi.org/10.1002/jia2.25974
dc.descriptionIntroduction: The HIV epidemic continues to disproportionately impact Latin-American transgender women (TGW). We assessed factors associated with long-term pre-exposure prophylaxis (PrEP) engagement and adherence among TGW enrolled in the Implementation of PrEP (ImPrEP) study, the largest PrEP demonstration study in Latin America. Methods: HIV-negative TGW aged ≥18 years reporting 1+eligibility criteria in the 6 months prior to enrolment (e.g. sex partner known to be living with HIV, condomless anal sex [CAS], transactional sex or having a sexually transmitted infection [STI]) who could safely take PrEP were enrolled. Follow-up visits were conducted at 4 weeks and then quarterly. We conducted logistic regression to identify factors associated with long-term PrEP engagement (3+ follow-up visits in 52 weeks) and complete self-reported adherence (no missed pills in the past 30 days) during follow-up. For both outcomes, we constructed multivariable models controlling for country, socio-demographics, sexual behaviour, substance use, STIs and self-reported adherence at 4 weeks (long-term engagement outcome only). Results: From March 2018 to June 2021, ImPrEP screened 519 TGW, enrolled 494 (Brazil: 190, Mexico: 66 and Peru: 238) and followed them for 52 weeks. At baseline, 27.5% of TGW were aged 18-24 years, 67.8% were mixed-race and 31.6% had >secondary education. Most, 89.9% reported CAS, 61.9% had >10 sex partners and 71.9% reported transactional sex. HIV incidence was 1.82 cases per 100 person-years (95% confidence interval [CI]: 0.76-4.38). Almost half of TGW (48.6%) had long-term PrEP engagement, which was positively associated with reporting complete adherence at week 4 (aOR:2.94 [95%CI:1.88-4.63]) and was inversely associated with reporting CAS with unknown-HIV partner (aOR:0.52 [95%CI:0.34-0.81]), migration (aOR:0.54 [95%CI:0.34-0.84]), and being from Mexico (aOR:0.28 [95%CI:0.14-0.53]). Self-reported adherence was associated with TGW aged >34 (aOR:1.61 [95%CI:1.10-2.34]) compared to those aged 25-34 and those with >secondary education (aOR:1.55 [95%CI:1.10-2.19]) and was lower among TGW from Peru (aOR:0.29 [95%CI:0.21-0.41]) or reporting PrEP-related adverse effects (aOR:0.63 [95%CI:0.42-0.92]). Conclusions: Although TGW were willing to enrol in ImPrEP, long-term PrEP engagement and complete self-reported adherence were limited, and HIV incidence remained relatively high. A successful HIV prevention agenda should include trans-specific interventions supporting oral PrEP and exploring long-acting PrEP strategies for TGW.es_ES
dc.formatPDFes_ES
dc.language.isoenges_ES
dc.publisherJohn Wiley & Sonses_ES
dc.relation25(S5):e25974
dc.rightsAcceso Cerradoes_ES
dc.titleFactors associated with long-term HIV pre-exposure prophylaxisengagement and adherence among transgender women in Brazil,Mexico and Peru: results from the ImPrEP studyes_ES
dc.typeArtículoes_ES
dc.contributor.affiliationUniversidad Peruana Cayetano Heredia, Centro de Investigaciones Interdisciplinaria en Salud, Sexualidad, y SIDA, Lima, Peru
dc.contributor.emailkelika.konda@upch.pe (Kelika A. Konda)
dc.relation.jnabreviadoJ INT AIDS SOC
dc.relation.journalJournal of the International AIDS Society
dc.identifier.placeSuiza
dc.date.published2022
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.eissn1758-2652
dc.identifier.doi10.1002/jia2.25974
dc.subject.kwPre-exposure prophylaxis
dc.subject.kwTransgender persons
dc.subject.kwHIV
dc.subject.kwLatin America
dc.subject.kwMedication adherence
dc.subject.kwPublic health


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