PrEP awareness and engagement among transgender women in South Africa: a cross-sectional, mixed methods study

Show simple item record 2022-08-17T12:54:17Z 2022-08-17T12:54:17Z 2020-09-01 en
dc.description.abstract The South African national HIV plan recommends pre-exposure prophylaxis (PrEP) for transgender women, whose HIV prevalence estimates are as high as 25% in sub-Saharan Africa. The aim of this study was to explore PrEP awareness, uptake, and willingness, as well as associated barriers and facilitators, in order to inform PrEP implementation efforts with transgender women in South Africa. Using a community-engaged, convergent parallel mixed methods design, trained local transgender women data collectors recruited 213 transgender women participants (aged >18 years, assigned male sex at birth, and identifying as a gender different from male), via network referral and word-of-mouth in Cape Town, East London, and Johannesburg. A subset of 36 transgender women also participated in qualitative in-depth interviews. Quantitative analyses included descriptive statistics and negative binomial regression models to assess correlates of PrEP willingness. Qualitative interviews were audio-recorded, transcribed verbatim, and coded. Thematic content analysis was used to identify key themes. Quantitative and qualitative data were integrated for interpretation. Participants were recruited between June 1 and Nov 30, 2018. 57 (45%) of 127 HIV-negative participants were PrEP-aware and only 14 (11%) of 129 were currently taking PrEP. HIV-negative participants experiencing social (eg, violence, poverty) and interpersonal (eg, discrimination, low transgender women community connectedness) hardship reported PrEP awareness more frequently than HIV-negative transgender women who did not. Willingness to take PrEP was low, at 56 (55%) of 102, among HIV-negative participants who were not currently taking PrEP, and negatively associated with transgender women community connectedness. Barriers to PrEP included taking a daily pill, side-effects, and cost. Participants urged greater education and engagement of transgender women in PrEP implementation. en
dc.format.medium Print en
dc.publisher Elsevier en
dc.subject HIV/AIDS en
dc.subject SOUTH AFRICA en
dc.subject WOMEN en
dc.subject TRANSGENDER en
dc.title PrEP awareness and engagement among transgender women in South Africa: a cross-sectional, mixed methods study en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber NA en
dc.Volume July en
dc.BudgetYear 2020/21 en
dc.ResearchGroup Human and Social Capabilities en
dc.SourceTitle Lancet HIV en
dc.ArchiveNumber 11599 en
dc.PageNumber Online en
dc.outputnumber 10670 en
dc.bibliographictitle Poteat, T., Malik, M., van der Merwe, L.L.A., Cloete, A., Adams, D., Nonyane, B.A.S. & Wirtz, A.L. (2020) PrEP awareness and engagement among transgender women in South Africa: a cross-sectional, mixed methods study. Lancet HIV. July:Online. en
dc.publicationyear 2020 en
dc.contributor.author1 Poteat, T. en
dc.contributor.author2 Malik, M. en
dc.contributor.author3 van der Merwe, L.L.A. en
dc.contributor.author4 Cloete, A. en
dc.contributor.author5 Adams, D. en
dc.contributor.author6 Nonyane, B.A.S. en
dc.contributor.author7 Wirtz, A.L. en

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