Zalazar Virginia, Arístegui Inés, Kerr Thomas, Marshall Brandon D L, Romero Marcela, Sued Omar, Socías M Eugenia
Fundación Huésped, Buenos Aires, Argentina.
Universidad de Palermo, Buenos Aires, Argentina.
Transgend Health. 2016 Dec 1;1(1):266-273. doi: 10.1089/trgh.2016.0033. eCollection 2016.
In Argentina, transgender women face a disproportionately high prevalence of HIV infection (34%). Although not currently approved in Argentina, pre-exposure prophylaxis (PrEP) may offer a potential effective HIV prevention tool for this population. In this study, we assessed the willingness to use PrEP among transgender women in Argentina. Data were drawn from a nationwide cross-sectional survey conducted among transgender women in 2013. Using multivariable logistic regression, we assessed the prevalence of and factors associated with willingness to use PrEP among transgender women with negative or unknown HIV status. This study included 337 transgender women (278 HIV negative and 59 with unknown HIV status), most of whom had a history of sex work involvement (81.8%). Overall, 301 (89.3%) expressed willingness to use PrEP. In a multivariable analysis, having casual sexual partners was positively associated with willingness to use PrEP (adjusted odds ratio [AOR]=4.26, 95% confidence interval [CI] 1.73-10.51), while discrimination by healthcare workers was negatively associated (AOR=0.33, 95% CI 0.12-0.88). We found high levels of willingness to use PrEP among transgender women in Argentina, suggesting that there is high perception of HIV risk in this population. However, discrimination by healthcare workers was a strong negative correlate of willingness to use PrEP, suggesting that multilevel interventions that address gender-based stigma in healthcare settings will be critical for the success of PrEP as an HIV prevention strategy in this population.
在阿根廷，跨性别女性感染艾滋病毒的比例极高（34%）。虽然暴露前预防（PrEP）目前在阿根廷尚未获批，但它可能为这一人群提供一种潜在有效的艾滋病毒预防工具。在本研究中，我们评估了阿根廷跨性别女性使用PrEP的意愿。数据来自2013年对跨性别女性进行的一项全国性横断面调查。我们使用多变量逻辑回归，评估了艾滋病毒检测呈阴性或状况不明的跨性别女性中使用PrEP意愿的患病率及相关因素。本研究纳入了337名跨性别女性（278名艾滋病毒检测呈阴性，59名状况不明），其中大多数有性工作经历（81.8%）。总体而言，301名（89.3%）表示愿意使用PrEP。在多变量分析中，有临时性伴侣与使用PrEP的意愿呈正相关（调整后的优势比[AOR]=4.26，95%置信区间[CI]为1.73 - 10.51），而医护人员的歧视则呈负相关（AOR=0.33，95%CI为0.12 - 0.88）。我们发现阿根廷的跨性别女性对使用PrEP的意愿很高，这表明该人群对艾滋病毒风险的认知度很高。然而，医护人员的歧视是使用PrEP意愿的一个强烈负相关因素，这表明解决医疗环境中基于性别的污名化问题的多层次干预措施对于PrEP作为该人群艾滋病毒预防策略的成功实施至关重要。
