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Research letter
Pre-exposure HIV prophylaxis (PrEP) among transgender women: 3 years of follow-up in a university hospital in Paris
  1. Valentina Isernia1,
  2. Bao Phung1,
  3. Annie Marie Lepretre1,
  4. Bahar Azadi2,
  5. Giovanna Rincon3,
  6. Julia Zelie1,4,
  7. Sylvie Le Gac1,4,
  8. Andres Deprez1,
  9. Florence Michard1,
  10. Yazdan Yazdanpanah1,5,
  11. Jade Ghosn1,5
  1. 1 Infectious Diseases, Hôpital Bichat—Claude-Bernard, Paris, France
  2. 2 CRIDUP, Centre de Recherche de l'Institut de Démographie de l'Université Paris 1, Paris, France
  3. 3 Acceptess-T, Paris, France
  4. 4 Corevih, Ile-de-France Nord, Paris, France
  5. 5 Inserm U1137 IAME, Faculté de Médecine site Bichat Université de Paris, Paris, France
  1. Correspondence to Dr Valentina Isernia, Infectious diseases, Hopital Bichat - Claude-Bernard, Paris, France; valentina.isernia{at}aphp.fr

Abstract

Objectives The principal outcome was to describe clinical characteristics of a transgender male-to-female (TGW) cohort followed for pre-exposure HIV prophylaxis (PrEP).

Introduction Few efforts and preventive interventions have targeted transgender population, despite them being at great risk of HIV infection.

Methods This was a retrospective transgender male-to-female (TGW) cohort followed for PrEP at Bichat Hospital Sexual Health Clinic between February 2016 and January 2019.

The principal outcome was to describe clinical characteristics of this TGW population: modalities of PrEP uptake, treatment adherence and tolerance, sanitary system retention, hormonal therapy and STIs.

Data about age, ethnicity, language, sex work and sanitary healthcare insurance coverage were also collected.

Results Forty-nine TGW were included, with a median age of 33 years; 43/49 (87.7%) were from South America and 43/49 (87.7%) were sex workers. Forty-four 44/49 TGW (89.7%) had no regular healthcare insurance coverage. Nineteen out of 49 (38.7%) had a history of STI in the last 12 months. Hormone intake was reported in 16/49 (32.60%). PrEP with oral TDF/FTC was prescribed on a daily basis for 45/49 TG (91.8%). Two TGW discontinued PrEP for gastrointestinal intolerance. No case of renal toxicity or HIV seroconversion has been reported. Retention rate was high (71.4%), but average follow-up was 9 months.

Conclusions Our data showed a very vulnerable population, with a high proportion of migrants, sex workers and with a low healthcare insurance coverage. Retention rate was high (71.4%). Further multi-component interventions are needed to improve global sex health approach, PreP follow-up and sanitary system retention among TGW population.

  • adherence
  • HIV pre-exposure prophylaxis
  • prostitution
  • transsexual

https://doi.org/10.1136/sextrans-2020-054618

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    Footnotes

    • Handling editor Anna Maria Geretti

    • Contributors VI, YY, GR and JG designed the study. BP, AML, FM, BA and VI were in charge of participants’ medical follow-up. JZ, SLG and AD were in charge of data extraction. VI and JG drafted the manuscript and all authors contributed to the final version of the manuscript. VI and JG had full access to the data and are guarantors of the overall content of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.