Sociodemographic and clinical follow-up profile of transgender people accessing pre-exposure prophylaxis for the risk of HIV transmission in São Paulo, Brazil (2018-2021)

Epidemiol Serv Saude. 2024 Dec 16;33(spe1):e2024342. doi: 10.1590/S2237-96222024v33e2024342.especial.en. eCollection 2024.
[Article in English, Portuguese]

Abstract

Objective: To describe the sociodemographic and clinical follow-up profile of the use of pre-exposure prophylaxis (PrEP) of HIV among transgender people receiving care at a reference health service for sexually transmitted infections and HIV/AIDS in São Paulo, the capital city of São Paulo state, between 2018 and 2021.

Method: This was a descriptive study with an analysis of sociodemographic data, reasons for seeking PrEP , discontinuation of use and experiences of clinical follow-up. Descriptive statistics were used.

Results: Among the 53 individuals, the majority were mixed-race (n= 25), transgender women (n= 48), heterosexual (n= 38) and had more than 11 years of study (n= 22). There was a decrease in follow-up visits (n= 14 to n= 3) after the second medical consultation.

Conclusion: It is necessary to develop strategies to increase PrEP dispensing and continuation among transgender people, especially among Black people and those with lower level of education.

Main results: The majority of pre-exposure prophylaxis (PrEP) users were young, mixed-race, educated transgender women, reflecting a portion of the transgender population with access to healthcare. The discontinuation of clinical follow-up, especially after the second medical consultation, requires attention.

Implications for services: Individualized strategies should be prioritized to improve the dispensing of PrEP and clinical follow-up for both transgender men and transgender women.

Perspectives: Further research should focus on investigation of strategies to increase PrEP dispensing and clinical follow-up for transgender people, with an emphasis on transgender men, Black people and those with lower level of education.

Objetivo: Describir el perfil sociodemográfico y el seguimiento del uso de la profilaxis preexposición (PrEP) para el VIH entre las personas transexuales atendidas en un servicio de salud de referencia para infecciones de transmisión sexual y VIH/sida en la ciudad de São Paulo entre 2018 y 2021.

Método: Estudio descriptivo que analizó datos sociodemográficos, motivos de búsqueda de PrEP, interrupción del uso y experiencias de seguimiento clínico. Se utilizó estadística descriptiva.

Resultados: Entre las 53 personas, la mayoría eran morenas (n=25), mujeres trans (n=48), heterosexuales (n=38) y con más de 11 años de escolaridad (n=22). Hubo una disminución de las visitas de seguimiento (de n=14 a n=3) a partir de la segunda consulta.

Conclusión: Es necesario desarrollar estrategias para aumentar la dispensación y la continuidad del uso de la PPrE entre las personas trans, especialmente entre las personas de raza negra y con menor nivel de escolarización.

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / administration & dosage
  • Brazil
  • Female
  • Follow-Up Studies
  • HIV Infections* / prevention & control
  • HIV Infections* / transmission
  • Humans
  • Male
  • Middle Aged
  • Pre-Exposure Prophylaxis* / statistics & numerical data
  • Sociodemographic Factors
  • Transgender Persons* / statistics & numerical data
  • Young Adult

Substances

  • Anti-HIV Agents

Grants and funding

This research was funded through a PhD scholarship awarded to Marcos Morais Santos Silva by the Coordination for the Improvement of Higher Education Personnel (CAPES), Process no. 88887.508615/2020-0.