Introduction Estimates of HIV prevalence amongst gender minorities are determined exclusively from scarce data for transgender women (TGW) who, globally, are disproportionately affected by HIV.¹ Data for transgender men (TGM) and non-binary individuals (NBI) are extremely limited. Transgender people are often identified as an underserved group for HIV prevention, however data on use of pre-exposure prophylaxis (PrEP) for HIV are lacking.^{2 3} This study aimed to determine the prevalence of PrEP use amongst transgender attendees at our sexual health service.

Methods All transgender people attending a single integrated sexual health service throughout 2021 were identified through GUMCAD coding and/or attendance at the services’ specialist trans clinic. Notes were reviewed for demographic data, PrEP eligibility and use. Confidence intervals (CI) were estimated with binomial exact test.

Results 108 patients were identified; 41/108 (38%) TGM, 38/108 (35%) TGW and 29/108 (27%) NBI. Median age was 36 years (IQR=24-38). 5(5%) were living with HIV, all TGW. 21/103 (20%) HIV negative patients were eligible for PrEP as per national guidelines. PrEP eligibility could not be determined from records for 15/103 (15%). 16/103 (16%, 95%CI=10-24) were currently using PrEP, 6(15%) TGM, 7(18%) TGW and 3(10%) NBI). A further 4 had previously used PrEP.

Discussion To our knowledge this is the first description of PrEP use amongst transgender people from a UK sexual health clinic. Only a small proportion were currently using PrEP, with most deemed not eligible. Further research is needed to determine whether this is reflective of the wider transgender population and to identify their diverse sexual health needs.

References

1. Baral S, Poteat T, Strömdahl S, Wirtz A, Guadamuz T and Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013; 13(3): 214-22.

2. World Health Organisation. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. Geneva: 2021.

3. Brady M, et al. BHIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP). HIV Med. 2019: 20; Suppl 2: s2-80.