Acceptability of Antiretroviral Pre-exposure Prophylaxis from a Cohort of Sexually Experienced Young Transgender Women in Two US Cities

Emtricitabine/tenofovir disoproxil fumarate as pre-exposure prophylaxis (PrEP) can prevent HIV infection among at-risk individuals, including young transgender women (YTW). We used baseline data from 230 HIV-uninfected YTW (ages 16-29years) who were enrolled in Project LifeSkills during 2012-2015. We examined factors associated with perceived acceptability of PrEP use (mean score=23.4, range 10.0-30.0). Participants were largely transgender women of color (67%) and had a mean age of 23years (SD=3.5). In an adjusted multiple linear regression model, PrEP interest (=3.7, 95% CI 2.2-5.2) and having a medical provider who meets their health needs (=2.9, 95% CI 1.3-4.4) was associated with higher PrEP acceptability scores, whereas younger age (21-25 vs 26-29years) (=-2.0, 95% CI -3.6 to -0.4) and reporting transactional sex in the past 4months (=-1.5, 95% CI -3.0 to -0.1) was associated with lower PrEP acceptability scores (all p values<0.05). Enhancing PrEP-related interventions by addressing the unique barriers to uptakeamong YTWof younger age or those with history of transactional sex could bolster PrEP acceptability for this population. ResumenEmtricitabine/tenofovir disoproxil fumarate como profilaxis preexposicion (PrEP) puede prevenir VIH en personas con alto riesgo, incluyendo mujeres jovenes transgenero (YTW). Usamos datos de linea base de 230 YTW sin infeccion por VIH inscritas en Project LifeSkills para examinar las variables asociadas con aceptabilidad de PrEP (promedio=23.4, intervalo=10.0-30.0). Participantes eran mayormente mujeres transgenero de color (67%) con edad promedia de 23 anos (DE=3.5). En un modelo de regresion lineal multiple, interes en PrEP (=3.7, 95% CI = 2.2-5.2) y tener un proveedor de atencion medica que cumple con sus necesidades (=2.9, 95% CI =1.3-4.4) era asociado con mayor aceptabilidad de PrEP, mientras que una edad menor (21-25 vs 26-29 anos) (=-2.0, 95% CI=-3.6--0.4) y sexo transaccional en los ultimos cuatro meses (=-1.5, 95% CI =-3.0--0.1) era asociado con menor aceptabilidad. Se necesitan intervenciones acerca de PrEP para YTW, sobre todo aquellas que han ejercido trabajo sexual, para aumentar la aceptabilidad de PrEP para esta poblacion.