ArticleJournal of the International AIDS Society2022
Low PrEP adherence despite high retention among transgender women in Brazil: the PrEParadas study.
Article in Journal of the International AIDS Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Behavioral and Structural Interventions for PrEP Adherence Among Young Female Sex Workers from Western Kenya.AIDS and behavior · 2026Trial
- Efficacy, safety, tolerability, and pharmacokinetics of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis in transgender women: a secondary analysis of the HPTN 083 trial.The lancet. HIV · 2023Trial
- Estradiol and Spironolactone Plasma Pharmacokinetics Among Brazilian Transgender Women Using HIV Pre-Exposure Prophylaxis: Analysis of Potential Interactions.Clinical pharmacokinetics · 2023Trial
- Using Tenofovir Diphosphate Levels to Evaluate Factors Associated With PrEP Non-Adherence and Performance of Indirect Adherence Measures in Latin America: A Prospective, Single-Arm, Open-Label, Multicentre Implementation Study (ImPrEP).Journal of the International AIDS Society · 2026Observational
- Persistence on Oral HIV Pre-Exposure Prophylaxis Among Key Populations at a Centre in Buenos Aires: A Survival Analysis of a Real-World Cohort.Journal of the International AIDS Society · 2026Article
- Longitudinal Analysis of Substance Use as a Predictor PrEP Use and Adherence Among Young Transgender Women and Nonbinary Individuals.AIDS and behavior · 2026Article
- Alcohol Use and the Care Continuum for HIV Preexposure Prophylaxis: An Updated Scoping Review of Research and Interventions.AIDS and behavior · 2026Review
- Alcohol Use Disorder Diagnoses and HIV Preexposure Prophylaxis Adherence and Continuation: a Retrospective Cohort Study.Journal of general internal medicine · 2026Article
- Understanding Factors Influencing HIV pre-exposure prophylaxis adherence among men who have sex with men in Western China: a data-driven exploration using bayesian networks.BMC public health · 2025Article
- High syphilis incidence among PrEP-adherent men who have sex with men and transgender women in Peru.Journal of the International AIDS Society · 2025Article
- Gender-Affirming Care as a Predictor of HIV Pre-Exposure Prophylaxis Use and Adherence Among Young Trans Feminine Adults: A Coincidence Analysis.Prevention science : the official journal of the Society for Prevention Research · 2025Article
- Exploring perceptions and preferences for PrEP choice and of an mHealth intervention: insights from the ImPrEP CAB-Brasil study.Journal of the International AIDS Society · 2025Article
- Mental Health Outcomes AmongInternational journal of environmental research and public health · 2025Review
- Intersectional discrimination, mental health, and health care access among transgender women in Brazil.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2025Article
- HIV prevention among adolescents travestis and transgender women in three Brazilian capitals, 2019-2023.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2025Article
- Access of transgender people and transvestites to pre-exposure prophylaxis for HIV in Brazil: a descriptive study, 2018-2023.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2025Article
- Access to healthcare for Trans, Travestis, and Gender-Diverse people in Latin America: a scoping review.Frontiers in public health · 2025Article
- Preparing for the Implementation of Long-Acting Injectable Cabotegravir for HIV Pre-Exposure Prophylaxis Within the Brazilian Public Health System (ImPrEP CAB Brasil): Qualitative Study.JMIR public health and surveillance · 2024Article
- Perceived Feasibility and Acceptability of HIV Prevention Research With Daily Oral PrEP Among Young Transgender Women (YTGW) Who Sell or Trade Sex in Bangkok and Pattaya, Thailand.AIDS education and prevention : official publication of the International Society for AIDS Education · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWe 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).
methodsWe 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.
resultsFrom 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.
conclusionsAlthough 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.
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