Amsterdam 2015
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| Abstract #2228 - Trans people - rights and services | ||||
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Session: 54.6: Trans people - rights and services (Parallel) on Friday @ 11.00-12.30 in 202 Chaired by Pum Kommattam, Jose Bauermeister Authors: Presenting Author: Dr Zixin Wang - The Chinese University of Hong Kong, Hong Kong |
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| Additional Authors: Dr Berthbsp;yssouf, Mme Fatoumata ouattara, Mlle Koua Tagna, | ||||
| Aim: Transgender women engaging in transactional sex serving men (TG-FSW) in feminine dressing was a sizable and high risk population in China. Pre-exposure Prophylaxis (PrEP) could effectively reduce the risk of HIV transmission among MSM. There is a dearth of studies investigating TG-FSW’s perceptions on PrEP. The present study investigated prevalence and associated factors of: 1) intention to use daily PrEP in the next six months if provided for free, 2) anticipated adherence to free daily PrEP among those who intend to use it and 3) anticipated risk compensation (i.e., would reduce condom use during transactional sex) under the hypothetical situation of using daily PrEP. | ||||
| Method / Issue: The inclusion criteria were: 1) self-reported gender identity as a transgender or transsexual woman (pre- or postoperative), 2) at least 18 years of age, 3) had anal intercourse with at least one male client in the last three months and 4) feminine dressing during transactional sex. Those who self-reported or tested to be HIV positive were excluded. With written informed consent, 163 participants completed the anonymous face-to-face interview by trained NGO staff in settings with privacy ensured. | ||||
| Results / Comments: Of all participants, 75.5% intended to use free daily PrEP after being briefed about it. 91.3% among those with a behavioral intention to use PrEP believed that they could adhere to daily PrEP. 33.8% of all participants indicated that they would reduce condom use during transactional sex under the hypothetical situation of using daily PrEP. After adjusting for background variables, perceived subjective norm favoring PrEP use (AOR=2.35), higher perceived behavioral control over using PrEP (AOR=3.89) and perceived good adherence (AOR=2.76) were positively associated with intention to use daily PrEP in the next six months, while negative attitude toward PrEP (AOR=0.67) was negatively associated with such an intention. Among those with behavioral intention to use PrEP, the adjusted analysis showed that positive attitudes toward PrEP (AOR=7.51), subjective norm favoring PrEP use (AOR=3.24), behavioral control over using PrEP (AOR=11.03), perceived social support (AOR=1.17) and self-esteem (AOR=1.65) were positively associated with anticipated adherence of daily PrEP, while poorer mental health status (higher score in CESD-20 and GAD-7) and higher perceived self-stigma were negatively associated with such an anticipation. In another adjusted analysis, drug use during transactional sex (AOR=4.24), perception that one would increase UAI to hide TG status from clients during transactional sex (AOR=1.29), positive attitude toward PrEP (AOR=1.70), anxiety assessed by GAD-7 (AOR=1.07) and higher self-stigma scale score (AOR=1.09) were positively associated with intention to reduce condom use during transactional sex in the case of using PrEP daily, while better self-esteem (AOR=0.84) was negatively associated with such an intention. | ||||
| Discussion: Majority of TG-FSW in China intended to use free PrEP and anticipated good adherence. Interventions to improve adherence of PrEP need to involve inter-personal components and emphasize psychological problems such as self-stigma and self-esteem. Caution should be given to potential risk compensation due to PrEP use, especially among those showing anxiety and self-stigma. Both psycho-social and cognitive factors should be considered when implementing PrEP in this population. | ||||
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