Built-in HIV prevention technique will increase PrEP adherence amongst transgender ladies

Researchers from the HIV Prevention Trials Community (HPTN) offered outcomes from HPTN 091 (“I Am Examine”) on the HIVR4P 2024 convention in Lima, Peru. The examine examined the acceptability and feasibility of an built-in multicomponent technique to boost day by day oral HIV pre-exposure prophylaxis (PrEP) uptake and adherence amongst transgender ladies in a randomized speedy versus deferred design.

The built-in care technique included the supply of gender-affirming hormone remedy (GAHT) and co-located structured peer well being navigation classes (PHN) together with oral PrEP. Individuals within the deferred arm obtained case administration and referral to GAHT. As soon as contributors reached week 26, all of them obtained the built-in care technique. The first consequence measured at week 26 confirmed a rise in PrEP uptake and an encouraging degree of PrEP adherence; nevertheless, PrEP uptake and adherence ranges had been the identical between examine arms.

General peer help and offering entry to GAHT and different wanted companies in each examine arms seemingly led to a rise in PrEP engagement amongst examine contributors, highlighting the important want for these helps on this inhabitants.”

Dr. Tonia Poteat, Professor, Duke College Faculty of Nursing

The examine enrolled 304 transgender ladies aged 18 and older at 4 U.S. HPTN analysis websites (Houston, New York, Philadelphia, and San Francisco) and one Brazil website (Rio de Janeiro). Individuals had been randomized 1:1 to the speedy versus deferred intervention arm. U.S. contributors in each examine arms had been supplied Truvada® (tenofovir/emtricitabine) or Descovy® (emtricitabine and tenofovir alafenamide) for HIV PrEP beginning at enrollment. Individuals in Brazil had been supplied Truvada®, consistent with the nationally accepted and out there PrEP product. Apretude® (cabotegravir) was unavailable on the time of the examine’s initiation and, due to this fact, not included as one of many PrEP choices.

At enrollment, contributors within the speedy intervention arm obtained GAHT and co-located structured PHN. Individuals within the deferred intervention arm obtained exterior GAHT and case administration as much as Week 26, then transitioned to the built-in technique afterward. PrEP uptake and adherence had been evaluated as the first examine consequence at week 26, with adherence outlined as taking 4 or extra drugs per week primarily based on tenofovir detection in dried blood spots.

“Transgender ladies have one of many highest HIV prevalence of any inhabitants but proceed to wrestle to entry and cling to PrEP,” mentioned Dr. Wafaa El-Sadr, HPTN co-principal investigator, director of ICAP, and professor of epidemiology and drugs at Columbia College in New York. “Tailoring methods to handle the distinctive wants of this inhabitants is important to addressing this problem.”

At enrollment, 11 p.c of contributors self-reported PrEP use, and 42 p.c reported GAHT use. At week 26, PrEP uptake was 85 p.c and 87 p.c within the speedy and deferred examine arms, respectively. PrEP adherence primarily based on dried blood spot outcomes was confirmed for 50 p.c and 51 p.c of the contributors, respectively. Retention was comparably excessive in each examine arms (84 p.c and 87 p.c, respectively).

“Significant involvement of the transgender group by means of the supply of peer-delivered case administration and entry to wanted companies was necessary to growing PrEP engagement amongst all examine contributors,” mentioned Dr. Myron Cohen, HPTN co-principal investigator, and director of the Institute for World Well being on the College of North Carolina in Chapel Hill. “This strategy gives a path to decreasing HIV acquisition on this inhabitants.”