Skip to main content
Journal cover image

Prevention-effective adherence trajectories among transgender women indicated for PrEP in the United States: a prospective cohort study.

Publication ,  Journal Article
Cooney, EE; Reisner, SL; Saleem, HT; Althoff, KN; Beckham, SW; Radix, A; Cannon, CM; Schneider, JS; Haw, JS; Rodriguez, AE; Wawrzyniak, AJ ...
Published in: Ann Epidemiol
June 2022

PURPOSE: Adherence to pre-exposure prophylaxis (PrEP) during periods of PrEP-indication (i.e., prevention-effective adherence) is critical for preventing HIV. We sought to describe factors associated with prevention-effective adherence trajectories among transgender women (TW) to inform PrEP implementation strategies. METHODS: Using data from The LITE American Cohort (n = 728), we performed group-based multi-trajectory modeling (GBMTM) to identify clusters of TW with similar trajectories of PrEP adherence and indication, and sociodemographic, biobehavioral, and structural correlates of each trajectory. RESULTS: We identified five trajectories: (1) consistent indication/no PrEP (15.3%), (2) initial indication/no PrEP (47.1%), (3) declining indication/discontinued PrEP (9.5%), (4) consistent indication/PrEP adherent (18.5%), and (5) increasing indication/initiated PrEP (9.6%). TW diagnosed with an STI were more likely to follow a consistent indication/no PrEP trajectory compared to consistent indication/PrEP adherent trajectory (adjusted Relative Risk Ratio [aRRR], 2.54; 95% confidence interval [CI], 1.16-5.57). TW who experienced homelessness were more likely to follow PrEP discontinuation and initiation trajectories relative to PrEP adherence (aRRR, 2.71; 95% CI, 1.10-6.70 and 2.83; 95% CI, 1.13-7.05, respectively). CONCLUSIONS: Over a quarter of TW followed trajectories suggestive of prevention-effective adherence, while 15% did not initiate PrEP despite consistent indication. Findings highlight missed opportunities for PrEP engagement at STI diagnosis and suggest structural interventions addressing housing instability may improve prevention-effective adherence among TW.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Ann Epidemiol

DOI

EISSN

1873-2585

Publication Date

June 2022

Volume

70

Start / End Page

23 / 31

Location

United States

Related Subject Headings

  • United States
  • Transgender Persons
  • Prospective Studies
  • Pre-Exposure Prophylaxis
  • Medication Adherence
  • Male
  • Humans
  • Homosexuality, Male
  • HIV Infections
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cooney, E. E., Reisner, S. L., Saleem, H. T., Althoff, K. N., Beckham, S. W., Radix, A., … American Cohort To Study HIV Acquisition Among Transgender Women (LITE) Study Group, . (2022). Prevention-effective adherence trajectories among transgender women indicated for PrEP in the United States: a prospective cohort study. Ann Epidemiol, 70, 23–31. https://doi.org/10.1016/j.annepidem.2022.03.016
Cooney, Erin E., Sari L. Reisner, Haneefa T. Saleem, Keri N. Althoff, S Wilson Beckham, Asa Radix, Christopher M. Cannon, et al. “Prevention-effective adherence trajectories among transgender women indicated for PrEP in the United States: a prospective cohort study.Ann Epidemiol 70 (June 2022): 23–31. https://doi.org/10.1016/j.annepidem.2022.03.016.
Cooney EE, Reisner SL, Saleem HT, Althoff KN, Beckham SW, Radix A, et al. Prevention-effective adherence trajectories among transgender women indicated for PrEP in the United States: a prospective cohort study. Ann Epidemiol. 2022 Jun;70:23–31.
Cooney, Erin E., et al. “Prevention-effective adherence trajectories among transgender women indicated for PrEP in the United States: a prospective cohort study.Ann Epidemiol, vol. 70, June 2022, pp. 23–31. Pubmed, doi:10.1016/j.annepidem.2022.03.016.
Cooney EE, Reisner SL, Saleem HT, Althoff KN, Beckham SW, Radix A, Cannon CM, Schneider JS, Haw JS, Rodriguez AE, Wawrzyniak AJ, Poteat TC, Mayer KH, Beyrer C, Wirtz AL, American Cohort To Study HIV Acquisition Among Transgender Women (LITE) Study Group. Prevention-effective adherence trajectories among transgender women indicated for PrEP in the United States: a prospective cohort study. Ann Epidemiol. 2022 Jun;70:23–31.
Journal cover image

Published In

Ann Epidemiol

DOI

EISSN

1873-2585

Publication Date

June 2022

Volume

70

Start / End Page

23 / 31

Location

United States

Related Subject Headings

  • United States
  • Transgender Persons
  • Prospective Studies
  • Pre-Exposure Prophylaxis
  • Medication Adherence
  • Male
  • Humans
  • Homosexuality, Male
  • HIV Infections
  • Female