Barriers and motivators to pre-exposure prophylaxis uptake among Black and Latina transgender women in Los Angeles: perspectives of current PrEP users

AIDS Care. 2021 Feb;33(2):244-252. doi: 10.1080/09540121.2020.1769835. Epub 2020 May 23.

Abstract

The purpose of this qualitative study was to identify barriers and motivators to PrEP uptake from the perspective of Black and Latina transgender women (TW) who are currently using PrEP to suggest intervention and outreach activities to increase PrEP uptake in this population. The Information-Motivation-Behavioral Skills Model guided the development of the semi-structured interview guide. A thematic analysis approach was used to analyze the data. Perceived barriers to PrEP uptake included structural and logistic barriers, language and cultural barriers to medical engagement, lack of transgender competent or gender-affirming care, and prioritizing hormone therapy over the use of PrEP. To increase PrEP uptake among BLTW, participants recommended disseminating PrEP information through a variety of methods, highlighting relationship and sexual health benefits of using PrEP, and developing effective patient-provider communication. Our findings highlight several ways to promote PrEP among BLTW. PrEP promotion should be integrated into gender-affirming care and supported by peer education and navigation services that reach BLTW in both clinic and community settings.

Keywords: African American; Black; Latina; pre-exposure prophylaxis; transgender women.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / therapeutic use
  • Black or African American / psychology*
  • Black or African American / statistics & numerical data
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / ethnology
  • HIV Infections / prevention & control*
  • Health Services Accessibility
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Los Angeles
  • Male
  • Medicare
  • Middle Aged
  • Pre-Exposure Prophylaxis*
  • Social Stigma
  • Transgender Persons / psychology*
  • Transgender Persons / statistics & numerical data
  • United States

Substances

  • Anti-HIV Agents