Department of Public Health, California State University, Sacramento, Solano Hall 3014, 6000 J Street, Sacramento, CA, 95819, USA.
School of Nursing, University of Texas at Austin, Austin, TX, USA.
Arch Sex Behav. 2021 May;50(4):1713-1728. doi: 10.1007/s10508-020-01903-8. Epub 2021 Jun 1.
Using a socioecological approach, this review describes the peer-reviewed literature on oral pre-exposure prophylaxis (PrEP) among both cisgender (cis women) and transgender women (trans women) in the U.S. A search of the PubMed database and HIV-related conference abstracts generated over 2,200 articles and abstracts. Of these, 103 fulfilled review inclusion criteria. Most of the existing research presents findings on individual-level factors associated with PrEP use such as willingness and perceived barriers. There was far less investigation of factors related to PrEP at more distal ecological levels. Though trans women are at greater risk of HIV infection than cisgender women, less is known about this population group with respect to PrEP despite their inclusion in many major clinical trials. Further, the literature is characterized by a persistent conflation of sex and gender which makes it difficult to accurately assess the reviewed research on HIV prevention and PrEP apart from risk group. Informed by these findings, we highlight specific opportunities to improve access to PrEP and reduce socioecological barriers to PrEP care engagement for cisgender and transgender women.
采用社会生态学方法，本综述描述了美国跨性别女性（trans women）和 cisgender 女性（cis women）中口服暴露前预防（PrEP）的同行评议文献。对 PubMed 数据库和与 HIV 相关的会议摘要进行了搜索，共生成了 2200 多篇文章和摘要。其中，有 103 篇符合审查纳入标准。现有的大多数研究都提出了与 PrEP 使用相关的个体层面因素的发现，如意愿和感知障碍。对于与 PrEP 相关的更遥远生态层面的因素的研究则少得多。尽管 trans women 感染 HIV 的风险高于 cisgender women，但针对这一人群的研究却很少，尽管他们被纳入了许多主要的临床试验。此外，文献的特点是持续混淆性别和性别的概念，这使得很难准确评估与 HIV 预防和 PrEP 相关的研究，而不是风险群体。根据这些发现，我们强调了为 cisgender 和 transgender 女性改善 PrEP 可及性和减少 PrEP 护理参与的社会生态障碍的具体机会。
