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P779 Pre-exposure prophylaxis use among trans and gender diverse people: characteristics and behaviour from the EPIC-NSW trial
  1. Stefanie Vaccher1,
  2. Rebecca Guy2,
  3. David Templeton3,
  4. Iryna Zablotska-Manos4,
  5. Shawn Clackett2,
  6. Martin Holt5,
  7. Garrett Prestage6,
  8. Janaki Amin7,
  9. Christine Selvey8,
  10. Fengyi Jin1,
  11. Andrew Grulich2,
  12. Benjamin Bavinton6
  1. 1The Kirby Institute, UNSW Sydney, Sydney, Australia
  2. 2Kirby Institute, Sydney, Australia
  3. 3RPA Sexual Health, Sydney, Australia
  4. 4Sydney Medical School Westmead, University of Sydney, Sydney, Australia
  5. 5Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
  6. 6UNSW Sydney, The Kirby Institute, Sydney, Australia
  7. 7Macquarie University, Sydney, Australia
  8. 8NSW Ministry of Health, Sydney, Australia


Background Trans and gender diverse (TGD) individuals are at higher risk of HIV than the general population. TGD individuals are under-represented among HIV pre-exposure prophylaxis (PrEP) users, hence little is known about their pill-taking behaviours. We describe demographic characteristics and PrEP adherence by TGD individuals in the EPIC-NSW study.

Methods From March 2016 to April 2018, 9,708 individuals were enrolled in EPIC-NSW. At baseline, then quarterly, participants were invited to complete an optional online behavioural and adherence survey. Factors previously associated with lower PrEP adherence were compared between TGD and non-TGD participants using chi-squared tests.

Results Of the 6,942 EPIC-NSW participants that completed any survey, 96 identified as TGD (1.4%), including 38 trans women and 15 trans men. TGD participants were significantly younger than non-TGD individuals (mean 34 vs 39 years, p<0.001) and less likely to be university educated (44% vs 60%, p=0.002). TGD individuals were more likely to identify as Indigenous Australian (11% vs 2%, p<0.001), although no more likely to have been born in Australia (p=0.634). 52% of TGD individuals reported being paid for sex by a man in the previous three months, compared to 8% of non-TGD participants (p<0.001). TGD participants were as likely as other participants to report using crystal methamphetamine (p=0.666), party drugs (p=0.572), or condomless sex in the previous three months (p=0.991). Taking at least four or seven PrEP pills in the previous week was reported in 87% and 91% (p=0.071) and 77% and 82% (p=0.06) of surveys completed by TGD and non-TGD individuals, respectively.

Conclusion Despite increased levels of HIV-risk and socio-economic disadvantage, TGD participants had comparable levels of adherence to non-TGD EPIC-NSW participants. Additional services for TGD including counselling and PrEP monitoring within a supportive environment may be warranted to ensure ongoing protection against HIV.

Disclosure No significant relationships.

  • transgender persons
  • risk behaviour

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