Study: Overall Uptake, Adherence to PrEP Low in Transgender Women


More than one-third of transgender women (TGW) not living with HIV at baseline were indicated for pre-exposure prophylaxis (PrEP).

More than one-third of transgender women (TGW) not living with HIV at baseline were indicated for pre-exposure prophylaxis (PrEP), according to a poster presented by the Johns Hopkins Bloomberg School of Public Health at the Conference on Retroviruses and Opportunistic Infections.

The objective of the Leading Innovation for Transgender Women’s Health and Empowerment (LITE) study was to analyze the PrEP care continuum among TGW and factors associated with PrEP indication. Using a multi-site cohort of TGW across 6 cities in the southern and eastern United States, participants underwent HIV/STI testing and completed a socio-behavioral survey at baseline.

As of April 2019, there were 751 participants not living with HIV at baseline. Thirty-nine percent met PrEP indication based on having had a laboratory confirmed STI, recent partner who was known to be living with HIV, reported recent sex work, and/or recent condom-less anal sex.

In addition, non-Hispanic black participants had a higher prevalence of being PrEP indicated. Having some college education or above was associated with being less likely to be PrEP-indicated.

Among those indicated for PrEP, 14% were currently using and adherent to PrEP; 84% of those indicated were aware of PrEP, and 76% of those aware of PrEP had health insurance. Following this, 63% of the individuals who were insured were taking PrEP and 68% of PrEP users reported 100% adherence within the prior 7 days of the survey.

Although most PrEP users were adherent, the overall uptake and adherence among those PrEP-indicated were low, which indicates that improving uptake and adherence among TGW warrants further investigation, according to the researchers. Future studies would focus on development of culturally appropriate strategies to increase uptake and adherence among black TGW PrEP indication is higher.


Malone JR, Reisner S, Wirtz AL. PrEP indication and care continuum among transgender women in the United States. Poster presented at: Conference on Retroviruses and Opportunistic Infections; March 8-11, 2020; Boston, MA. Accessed April 9, 2020.

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