166 - Awareness of Biomedical HIV Prevention Methods and Attitudes toward Pre-Exposure Prophylaxis (PrEP) among Adolescent and Young Adult Transgender Men

Poster Number: 166
Publication Number: 166.108

Background: Although young transgender men and transmasculine people (hereafter TGM) are at risk of human immunodeficiency virus (HIV), little is known about awareness of and attitudes toward biomedical HIV prevention, including post- and pre-exposure prophylaxis (PEP and PrEP), in this population.

Objective: Our objective was to explore current HIV prevention practices, awareness of PEP and PrEP, and attitudes toward PrEP among adolescent and young adult TGM.

Design/Methods: Fifteen TGM ages 15-24 years participated in semi-structured individual interviews between 11/2022-3/2023. Youth were recruited from a dedicated gender clinic at a U.S. Midwestern pediatric institution. Theory-informed interviews conducted by one interviewer assessed demographics, current HIV prevention practices, awareness of PEP and PrEP, and attitudes toward PrEP. Transcripts were analyzed using framework analysis. The IRB approved the study.

Results: Mean age was 17.7 years (SD 1.4). Most participants (n=12) identified as White, 2 Biracial, and one Black; one was Hispanic. Thirteen participants were sexually active; median lifetime number of partners of 2 (range 0-10). Current HIV prevention strategies included abstinence (n=7), safer sexual practices such as being aware of partners’ histories (n=5) and condom use (n=5), personal and partner testing for HIV and other sexually transmitted infections (n=4), and not sharing needles for hormone injections (n=3). Very few participants (n=2) were aware of PEP. Although nearly half (n=7) of participants were aware of PrEP, 5 of these had no specific knowledge about it. Participants reported various perceived benefits of and barriers to PrEP use, as shown in Tables 1 and 2 respectively together with illustrative quotations. Facilitating factors for PrEP use included higher personal perceived risk of HIV (n=14), learning more about PrEP and HIV (n=7), having access to PrEP (i.e., knowing where to get it, transportation; n=3), discussing PrEP with important others (n=2), and PrEP being affordable (n=1). Most participants (n=13) reported a high degree of control over taking PrEP if they wanted to take it.

Conclusion(s): Awareness of both PEP and PrEP was low in this sample of TGM. While increasing awareness and knowledge of these options is critical, addressing other perceived barriers, including access to PrEP services, support for transportation, and ensuring affordable PrEP care, are also necessary to improve uptake of PrEP in TGM youth.
Funded by Gilead Sciences, Inc. investigator-initiated grant (PI: Mullins)