TY - JOUR
T1 - PrEP Disparities Among Transgender Feminine, Transgender Masculine, Nonbinary, and Gender Expansive Youth and Young Adults in the United States
AU - Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) CARES Team
AU - Fehrenbacher, Anne E.
AU - Cain, Demetria
AU - Rusow, Joshua A.
AU - Lakshmanan, Swetha
AU - Polanco, Dianna
AU - Ward, Demi
AU - Tapia, Yara
AU - Flynn, Risa P.
AU - Sullivan, Patrick S.
AU - Comulada, W. Scott
AU - Horvath, Keith J.
AU - Reback, Cathy J.
AU - Swendeman, Dallas T.
AU - Fournier, Jasmine
AU - Harris, Danielle
AU - Lightfoot, Marguerita
AU - Milburn, Norweeta
AU - Arnold, Elizabeth Mayfield
AU - Mitchell, Kate
AU - Cortado, Ruth
AU - Shannon, Chelsea
AU - Kerin, Tara
AU - Bryson, Yvonne
AU - Nielsen, Karin
AU - Tang, Wenze
AU - Brookmeyer, Ronald
AU - Weiss, E. E.
AU - Koussa, Maryann
AU - Lee, Sung Jae
AU - Klausner, Jeffrey D.
AU - Fernandez, M. Isabel
AU - Abdalian, Sue Ellen
AU - Rotheram-Borus, Mary Jane
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/4
Y1 - 2025/4
N2 - This study assessed disparities in pre-exposure prophylaxis (PrEP) use among transgender and gender expansive youth and young adults (N = 477) between 15 and 24 years old in the CARES (ATN 149) and TechStep (ATN 160) study protocols within the National Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). Structural equation modeling was used to test mediation pathways between gender identity and PrEP uptake among the full sample and stratified by sex assigned at birth. Lifetime PrEP uptake was higher among those assigned male at birth (26%) versus assigned female at birth (9%), explained by greater structural and behavioral risks and perceived need for PrEP, especially among trans women. Among those assigned female at birth, PrEP uptake was higher among trans men (12%) than nonbinary participants (6%). Our findings characterize key structural and behavioral drivers of PrEP use and highlight the need to reduce barriers to healthcare for trans youth, particularly in the South.
AB - This study assessed disparities in pre-exposure prophylaxis (PrEP) use among transgender and gender expansive youth and young adults (N = 477) between 15 and 24 years old in the CARES (ATN 149) and TechStep (ATN 160) study protocols within the National Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). Structural equation modeling was used to test mediation pathways between gender identity and PrEP uptake among the full sample and stratified by sex assigned at birth. Lifetime PrEP uptake was higher among those assigned male at birth (26%) versus assigned female at birth (9%), explained by greater structural and behavioral risks and perceived need for PrEP, especially among trans women. Among those assigned female at birth, PrEP uptake was higher among trans men (12%) than nonbinary participants (6%). Our findings characterize key structural and behavioral drivers of PrEP use and highlight the need to reduce barriers to healthcare for trans youth, particularly in the South.
KW - Adolescents
KW - Disparities
KW - HIV prevention
KW - PrEP
KW - Transgender
UR - https://www.scopus.com/pages/publications/85217563168
U2 - 10.1007/s10461-024-04590-x
DO - 10.1007/s10461-024-04590-x
M3 - Article
C2 - 39885012
AN - SCOPUS:85217563168
SN - 1090-7165
VL - 29
SP - 1136
EP - 1157
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 4
ER -