| Author | Jalil, Emilia M. | |
| Author | Torres, Thiago S. | |
| Author | Luz, Paula M. | |
| Author | Monteiro, Laylla | |
| Author | Moreira, Ronaldo I. | |
| Author | Castro, Cristiane R. V. de | |
| Author | Leite, Iuri da C. | |
| Author | Cunha, Marcello | |
| Author | Estrela, Rita de Cássia Elias | |
| Author | Ramos, Michelle | |
| Author | Hoagland, Brenda | |
| Author | Cardoso, Sandra Wagner | |
| Author | Anderson, Peter | |
| Author | Veloso, Valdiléa G. | |
| Author | Wilson, Erin | |
| Author | Grinsztejn, Beatriz | |
| Access date | 2022-10-20T23:41:57Z | |
| Available date | 2022-10-20T23:41:57Z | |
| Document date | 2022 | |
| Citation | JALIL, Emilia M. et al. Low PrEP adherence despite high retention among transgender women in Brazil: the PrEParadas study. Journal of the International AIDS Society, v. 25, n. 3, p. 1-10, 2022. | en_US |
| ISSN | 1758-2652 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/55225 | |
| Description | PrEParadas Study Team: Isabele Moura, Leonardo Eksterman, Daniel M McMahon Waite, Desirée Vieira, José Roberto Granjeiro, Josias Freitas, Toni Santos, Nilo Fernandes, Vitoria Berg Cattani, Sandro Nazer, Luana M. S. Marins, Valéria R. T. Ribeiro, Robson P. N. Silva, Giovanna G. Costa, Ana Carolina Vieira, Renata A. Bastos, Aline Alves, Tania Krstic, Ana Cristina G. Ferreira, Monica Derrico, Luciana Kamel, Cristina M. Jalil, Eduardo Carvalheira Netto, Marcos Davi G. de Sousa, Pedro Leite, Kim Geraldo Mattos, Jessica Bezerra Felix, Tamires Vilela Baião, Gisele Hottz, Natália Gomes Maia, Tamiris Paixão da Silva, Tiago Porto. | |
| Sponsorship | This study was sponsored by the Brazilian Ministry of Health (Brasília, Brazil; #01/2013 BRA/K57) and Secretaria de Vigilancia em Saúde (SVS; #281/2013). Gilead Sciences donated the study drug and covered costs related to drug concentration assessment, but had no role in study design, collection, analysis and interpretation of data, writing of the manuscript or the decision to submit the manuscript for publication. | |
| Language | eng | en_US |
| Publisher | Wiley | en_US |
| Rights | open access | en_US |
| Title | Low PrEP adherence despite high retention among transgender women in Brazil: the PrEParadas study | en_US |
| Type | Article | en_US |
| DOI | 10.1002/jia2.25896 | |
| Abstract | Introduction: We aimed to evaluate daily oral pre-exposure prophylaxis (PrEP) uptake, retention, and adherence and predictors of study non-attendance and low PrEP adherence in a Brazilian trans-specific 48-week study (PrEParadas). Methods: We enrolled transgender women (TGW) engaging in high-risk sexual behaviours between August 2017 and December 2018. PrEP adherence was based on tenofovir diphosphate concentrations in dried blood spots (DBS). We used random effects logistic regression models and ordinal models to estimate the odds of having a missed visit and of low PrEP adherence, respectively. Multivariable models were adjusted for variables with p-value<0.10 in the univariate analysis. Results: From the 271 eligible, 130 participants were enrolled in the study (PrEP uptake: 48%), out of which 111 (85.4%) were retained at 48 weeks. Multivariable model for study non-attendance included study visit, age, main sexual partner and stimulant use. The odds of missing a visit increased after the week 24. Participants aged 18-24 (adjusted odds ratio [aOR] = 8.76, 95% CI: 2.09-36.7) and 25-34 years (aOR = 6.79, 95% CI: 1.72-26.8) compared to TGW aged 35+ years had significantly higher odds of having a missed visit. The odds of a missed visit were higher among participants reporting stimulant use (aOR = 4.99, 95% CI: 1.37-18.1) compared to no stimulant use. DBS levels at week 48 showed that 42 (38.5%), 14 (12.8%) and 53 (48.6%) of 109 participants had low, moderate and high PrEP adherence. Multivariable model for low PrEP adherence included study visit, age, schooling, race/colour, housing, binge drinking, stimulant use, feminizing hormone therapy (FHT) use and received text message. Low PrEP adherence was significantly higher among participants with less years of schooling (aOR = 6.71, 95% CI: 1.30-34.5) and had a borderline association with Black colour/race (aOR = 6.72, 95% CI: 0.94-47.8). Participants using the FHT available at the site had decreased odds of low PrEP adherence (aOR = 0.38, 95% CI: 0.16-0.88). No participant seroconverted over the course of the study. Conclusions: Although high PrEP retention can be achieved in a gender-affirming setting, PrEP adherence may be an important challenge faced among TGW due to social disparities. The scale-up of prevention tools like PrEP will have to address systemic social determinants as these stand as important barriers for TGW's access to health services. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Escola Nacional de Saúde Publica Sergio Arouca. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Escola Nacional de Saúde Publica Sergio Arouca. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | University of Colorado. Department of Pharmaceutical Sciences. Aurora, Colorado, USA. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | San Francisco Department of Public Health. San Francisco, California, USA. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
| Subject | HIV | en_US |
| Subject | PrEP | en_US |
| Subject | Hormones | en_US |
| Subject | Prevention | en_US |
| Subject | Transgender women | en_US |
| Subject | Adherence | en_US |
| xmlui.metadata.dc.subject.ods | 05 Igualdade de gênero | |
