BRIEF RESEARCH REPORT article
Front. Public Health
Sec. Life-Course Epidemiology and Social Inequalities in Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1626060
This article is part of the Research TopicPublic Health Innovations Inspired by Transgender Day of VisibilityView all articles
Social determinants of health are associated with low uptake of daily HIV pre-exposure prophylaxis and with future uptake of long-acting formats: a survey of Black and Latina/x/e transfeminine adults' in Chicago
Provisionally accepted
- 1School of Public Health, University of Alabama at Birmingham, Birmingham, United States
- 2Howard Brown Health, Chicago, IL, United States
- 3TaskForce Prevention & Community Services, Chicago, IL, United States
- 4Chicago Therapy Collective, Chicago, IL, United States
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The transgender population in the United States continue to experience disproportionately high HIV prevalence, and Black and Latina transgender women in particular account for more than half of the population's new diagnoses. Uptake of PrEP, the daily oral HIV prevention pill, among Black and Latina transfeminine adults has lagged. This communityengaged, HIV status-neutral study served as an initial investigation of Black and Latina/x/e transfeminine adults' attitudes toward various long-acting formats of PrEP relative to the daily pill.Methods: An online survey was conducted in Chicago, IL in 2023 (N=198). Multiple logistic regression was conducted to identify associations with the most highly preferred long-acting PrEP format. Secondarily, we compared who would be indicated for daily PrEP based on 2021 CDC eligibility guidance to those reporting current uptake of the daily pill. Results: Our findings indicate having a college degree or higher (aOR=6.73 [95% CI: 2.18-20.81], p<0.001) and full-time employment (aOR=2.70 [95% CI: 1.19-6.17], p=0.018) were associated with reporting a preference for taking the monthly pill while controlling for age group, race, and sexual orientation. Secondarily, those currently taking PrEP were disproportionately stably housed, and 54% reported no CDC-endorsed indications. The positive predictive value of the 2021 CDC PrEP eligibility guidance was 0.30. Discussion: Similar to other populations vulnerable to HIV, social determinants of health were associated with a preference for the long-acting pill and with current uptake of the daily pill.These findings signal a need for additional research into innovative PrEP implementation strategies that mitigate the structural barriers that transfeminine adults face.
Keywords: transgender (binary and non-binary), HIV prevention (PrEP), social determinants of health, racial inequities, Community Engagement, implementation science, Transfeminine
Received: 09 May 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Thompson, Schafer, Ortiz, Leslie and Rivera. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hale M Thompson, School of Public Health, University of Alabama at Birmingham, Birmingham, United States
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