- Title Information
- Title
- The association between healthcare system interactions and PrEP usage among transgender and gender nonconforming adults in Massachusetts and Rhode Island
- Type of Resource (primo)
- dissertations
- Name:
Personal
- Name Part
- Rofe, Kara
- Role
- Role Term:
Text
- creator
- Name:
Personal
- Name Part
- Pearlman, Deborah
- Role
- Role Term:
Text
- Reader
- Name:
Personal
- Name Part
- Hughto, Jaclyn
- Role
- Role Term:
Text
- Advisor
- Name:
Corporate
- Name Part
- Brown University. School of Public Health
- Role
- Role Term:
Text
- sponsor
- Origin Information
- Copyright Date
- 2022
- Physical Description
- Extent
- v, 28 p.
- digitalOrigin
- born digital
- Note:
thesis
- Thesis (M. P. H.)--Brown University, 2022
- Genre (aat)
- theses
- Abstract
- Background: Transgender and gender nonconforming (TGNC) adults are disproportionately impacted by HIV. Despite the high efficacy of pre-exposure prophylaxis (PrEP) to prevent HIV, research suggests that PrEP is underutilized among TGNC people. Research is needed to identify which subgroups of at-risk TGNC people are not utilizing PrEP.
Methods: In 2019, a survey assessing PrEP knowledge and use, healthcare experiences, sexual risk behavior and demographics was administered to 600 TGNC adults in Massachusetts and Rhode Island in-person and online. For the current analysis, the sample was restricted to HIV-negative individuals who had reported one or more HIV risk behaviors, including having sexual contacts with six or more people in the past 6 months, engaging in condomless sex in the past 6 months, having a lifetime history of STIs, and engaging in sex work in the past year, resulting in an analytic sample of n=166. An age-adjusted multivariable logistic regression model tested the association between condomless sex in the past 6 months, lifetime history of STIs, accessing HIV prevention services in the past 12 months and the outcome: lifetime non-utilization of PrEP.
Findings: The mean age of this high HIV-risk sample of TGNC adults was 30.8 years old (SD=10.0) and 81.9% were White non-Hispanic. Overall, 31.3% were trans feminine, 24.7% were trans masculine, and 44.0% were non-binary. PrEP awareness was high (80.7%) but few had a history of taking PrEP (14.5%). In the age-adjusted multivariable model, not accessing HIV prevention services in the past 12 months months (aOR=21.14, 95% CI=6.43, 69.49), never having an STI (aOR=3.10, 95% CI= 1.02, 9.39), and engaging in condomless anal or vaginal sex in the past 6 months (aOR=3.84, 95% CI= 1.12, 13.14) were associated with the increased odds of never having used PrEP.
Conclusion: This study represents the first to our knowledge to quantitatively assess factors associated with not using PrEP in a multistate sample of TGNC adults who are HIV negative and at-risk for the virus. The findings extend a body of evidence documenting the lack of PrEP usage among TGNC adults. The low number of at-risk TGNC people who used PrEP indicates the need for structural and clinical interventions to increase PrEP access among this population.
- Subject
- Topic
- Pre-exposure prophylaxis
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01015324")
- Topic
- Medicine, Preventive
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01076117")
- Topic
- Preventive health services
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01765239")
- Topic
- Transgender people
- Subject
- Topic
- LGBT health
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01202158")
- Topic
- Sexual minorities
- Language
- Language Term (ISO639-2B)
- English
- Record Information
- Record Content Source (marcorg)
- RPB
- Record Creation Date
(encoding="iso8601")
- 20220706