PrEP may be increasingly popular among gay and bisexual men but has yet to catch on with transgender and gender non-conforming people.
The Los Angeles LGBT Center is seeking volunteers for a study delving into the reasons why, particularly since transgender women have a high rate of HIV infection.
This is the first PrEP study focusing specifically on transgender and gender non-conforming people. Participants will be monitored during the time they take the HIV prevention pill and compensated for their time.
“It’s a population that is at very high risk for HIV infection,” says Risa Flynn, the Center’s Health Services Senior Manager of Research. “But there’s some reluctance to be on PrEP or be part of the study at all. What we’ve found with studies like this is it takes time for word of mouth to spread.”
PrEP (Pre-Exposure Prophylaxis) involves taking a pill called Truvada which can prevent HIV from infecting healthy cells. The regimen requires taking one pill a day.
The study involves six visits over a one-year period. Participants, like everyone who is on PrEP, will have regular lab tests conducted to make sure their kidneys are healthy and that the pill isn’t having any adverse effects on their general health. There is also a behavioral survey involved. The study provides routine testing for HIV and sexually transmitted infections and looks at whether Truvada has an impact on hormones.
“For individuals who are on hormone replacement therapy, that’s often the highest priority and many times they’ll say: ‘I want to go on PrEP but I’m afraid it’s going to have an impact,’” says Flynn.
The only eligibility requirements are that someone be 18 years or older, identify as transgender or gender non-conforming and be sexually active and HIV-negative.
Flynn says the study is a ‘win-win’ proposition for those who choose to participate.
“Just having access to medical care is sometimes hard for transgender and gender non-conforming people, so this makes it a little bit easier,” she says. “If they join the study, they will be able to get resources for medical help so they can have access to hormone replacement therapy if they’re not already on it. And of course, they’ll get PrEP for free.”
Adherence will also be tracked with participants getting daily text messages reminding them to take their PrEP. They text back after they have taken the drug. If they miss three doses, they will get a phone call from a member of the study team to discuss ways to improve.
A separate component of the study focuses on whether participants are having employment, housing or substance use issues and whether they have access to a primary care physician. As a whole, transgender people generally have greater health challenges.
“If we address some of the barriers to healthcare, can we increase the likelihood that someone will prioritize PrEP?,” asks Flynn. “Rather than just talking about sexual risk, we’re considering the many competing needs and challenges in the lives of transgender people.”