Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil

Detalhes bibliográficos
Autor(a) principal: Echeverría-Guevara, Amanda
Data de Publicação: 2023
Outros Autores: Coelho, Lara E., Veloso, Valdiléa G., Pimenta, Maria C., Hoagland, Brenda, Moreira, Ronaldo I., Leite, Iuri, Jalil, Emília M., Cardoso, Sandra W., Torres, Thiago S., Grinsztejn, Beatriz
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/57958
Resumo: Our results revealed populations with higher odds of PrEP ELFU including TGW, young individuals and those with lower education. These same populations share a disproportionate high risk of HIV acquisition. Moreover, we found high ELFU among same-day PrEP users in routine PrEP care. Identification of barriers to PrEP continuation as well as providersdriven tailored strategies for these high-risk groups are needed to improve PrEP retention in care. Further studies aiming to investigate interventions (i.e., technology-based or peer navigation-based) to facilitate PrEP use among TGW and young individuals are ongoing and could lead to new tools to improve PrEP outcomes in these populations.
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spelling Echeverría-Guevara, AmandaCoelho, Lara E.Veloso, Valdiléa G.Pimenta, Maria C.Hoagland, BrendaMoreira, Ronaldo I.Leite, IuriJalil, Emília M.Cardoso, Sandra W.Torres, Thiago S.Grinsztejn, Beatriz2023-04-24T23:18:06Z2023-04-24T23:18:06Z2023ECHEVERRÍA-GUEVARA, Amanda et al. Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil. The Brazilian Journal of Infectious Diseases, v. 27, n. 1, p. 1-9, Jan./Feb. 2023.1413-8670https://www.arca.fiocruz.br/handle/icict/5795810.1016/j.bjid.2022.1027331678-4391Our results revealed populations with higher odds of PrEP ELFU including TGW, young individuals and those with lower education. These same populations share a disproportionate high risk of HIV acquisition. Moreover, we found high ELFU among same-day PrEP users in routine PrEP care. Identification of barriers to PrEP continuation as well as providersdriven tailored strategies for these high-risk groups are needed to improve PrEP retention in care. Further studies aiming to investigate interventions (i.e., technology-based or peer navigation-based) to facilitate PrEP use among TGW and young individuals are ongoing and could lead to new tools to improve PrEP outcomes in these populations.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. PrEP Brasil was sponsored by the Brazilian Ministry of Health, Conselho Nacional de Desenvolvimento Científico e Tecnologico (CNPq), Fundação Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) and Fundação de Amparo ~ a Pesquisa do Estado de Sao Paulo (FAPESP). ImPrEP project was made possible thanks to Unitaid’s funding and support. Unitaid accelerates access to innovative health products and lays the foundations for their scale-up by countries and partners. Unitaid is a hosted partnership of WHO. Imprep was also supported by the Brazilian Ministry of Health.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Ministério da Saúde. Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis. Brasília, DF, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.Introduction: Oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir (FTC/TDF) is highly effective in preventing HIV infection. This study aimed to identify factors associated with PrEP early loss to follow-up (ELFU) among gay, bisexual and other men who have sex with men (MSM), travestis and transgender women (TGW). Methodology: This was a prospective cohort study evaluating TGW and MSM who initiated PrEP at the Evandro Chagas National Institute of Infectious Diseases (INI-Fiocruz) from 2014 to 2020. ELFU was defined as not returning for a PrEP visit within 180 days after first dispensation. Exposure variables included age, gender, race, education, transactional sex, condomless anal intercourse [CAI] (both in the past six months), binge drinking and substance use (both in past three months) and syphilis diagnosis at baseline. Multilevel logistic regression models with random intercepts and fixed slopes were used to identify factors associated with ELFU accounting for clustering of participants according to their PrEP initiation study/context (PrEP Brasil, PrEParadas, ImPrEP and PrEP SUS). Results: Among 1,463 participants, the median age was 29 years (interquartile range 24-36), 83% self-identified as MSM, 17% as TGW, 24% were black, 37% mixed-black/pardo and 30% had < 12 years of education. Fifteen percent reported transactional sex, 59% reported CAI, 67% binge drinking, 33% substance use, and 15% had a syphilis diagnosis. Overall, 137 participants (9.7%) had ELFU. Younger age (18-24 years) (adjusted odds ratio [aOR] 1.9, 95%CI:1.2-3.2), TGW (aOR 2.8, 95%CI:1.6-4.8) and education < 12 years (aOR 1.9, 95%CI:1.2-2.9) were associated with greater odds of ELFU. Conclusion: TGW, young individuals and those with lower education were at higher risk of PrEP ELFU. Our results suggest that the development of specific strategies targeting these populations should be a priority, through policies that aim to reduce the incidence of HIV infection.engSociedade Brasileira de InfectologiaTravestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleHIVLatin AmericaLost to follow-upMSMPre-exposure prophylaxisSexual and gender minoritiesTransgender personinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.en_US.fl_str_mv Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil
title Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil
spellingShingle Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil
Echeverría-Guevara, Amanda
HIV
Latin America
Lost to follow-up
MSM
Pre-exposure prophylaxis
Sexual and gender minorities
Transgender person
title_short Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil
title_full Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil
title_fullStr Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil
title_full_unstemmed Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil
title_sort Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil
author Echeverría-Guevara, Amanda
author_facet Echeverría-Guevara, Amanda
Coelho, Lara E.
Veloso, Valdiléa G.
Pimenta, Maria C.
Hoagland, Brenda
Moreira, Ronaldo I.
Leite, Iuri
Jalil, Emília M.
Cardoso, Sandra W.
Torres, Thiago S.
Grinsztejn, Beatriz
author_role author
author2 Coelho, Lara E.
Veloso, Valdiléa G.
Pimenta, Maria C.
Hoagland, Brenda
Moreira, Ronaldo I.
Leite, Iuri
Jalil, Emília M.
Cardoso, Sandra W.
Torres, Thiago S.
Grinsztejn, Beatriz
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Echeverría-Guevara, Amanda
Coelho, Lara E.
Veloso, Valdiléa G.
Pimenta, Maria C.
Hoagland, Brenda
Moreira, Ronaldo I.
Leite, Iuri
Jalil, Emília M.
Cardoso, Sandra W.
Torres, Thiago S.
Grinsztejn, Beatriz
dc.subject.en.en_US.fl_str_mv HIV
Latin America
Lost to follow-up
MSM
Pre-exposure prophylaxis
Sexual and gender minorities
Transgender person
topic HIV
Latin America
Lost to follow-up
MSM
Pre-exposure prophylaxis
Sexual and gender minorities
Transgender person
description Our results revealed populations with higher odds of PrEP ELFU including TGW, young individuals and those with lower education. These same populations share a disproportionate high risk of HIV acquisition. Moreover, we found high ELFU among same-day PrEP users in routine PrEP care. Identification of barriers to PrEP continuation as well as providersdriven tailored strategies for these high-risk groups are needed to improve PrEP retention in care. Further studies aiming to investigate interventions (i.e., technology-based or peer navigation-based) to facilitate PrEP use among TGW and young individuals are ongoing and could lead to new tools to improve PrEP outcomes in these populations.
publishDate 2023
dc.date.accessioned.fl_str_mv 2023-04-24T23:18:06Z
dc.date.available.fl_str_mv 2023-04-24T23:18:06Z
dc.date.issued.fl_str_mv 2023
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv ECHEVERRÍA-GUEVARA, Amanda et al. Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil. The Brazilian Journal of Infectious Diseases, v. 27, n. 1, p. 1-9, Jan./Feb. 2023.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/57958
dc.identifier.issn.en_US.fl_str_mv 1413-8670
dc.identifier.doi.none.fl_str_mv 10.1016/j.bjid.2022.102733
dc.identifier.eissn.none.fl_str_mv 1678-4391
identifier_str_mv ECHEVERRÍA-GUEVARA, Amanda et al. Travestis, transgender women and young MSM are at high risk for PrEP early loss to follow-up in Rio de Janeiro, Brazil. The Brazilian Journal of Infectious Diseases, v. 27, n. 1, p. 1-9, Jan./Feb. 2023.
1413-8670
10.1016/j.bjid.2022.102733
1678-4391
url https://www.arca.fiocruz.br/handle/icict/57958
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Sociedade Brasileira de Infectologia
publisher.none.fl_str_mv Sociedade Brasileira de Infectologia
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
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reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/57958/1/license.txt
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repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv repositorio.arca@fiocruz.br
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