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Preexposure Prophylaxis Uptake Among Spanish-Speaking Transgender Women: A Randomized Controlled Trial in North and
Scott D Rhodes1, Jorge Alonzo1, Lilli Mann-Jackson1
1Scott D. Rhodes, Jorge Alonzo, Lilli Mann-Jackson, and Manuel Garcia are with the Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC. At trial initiation, Lucero Refugio Aviles was with the Triad Health Project, Greensboro, NC; she completed the study while at the Department of Social Sciences and Health Policy, Wake Forest University School of Medicine. Amanda E. Tanner and Tamar Goldenberg are with the Department of Public Health Education, University of North Carolina, Greensboro. Carla A. Galindo, Patricia A. Bessler, and Cari Courtenay-Quirk are with the US Centers for Disease Control and Prevention, Atlanta, GA. Ana D. Sucaldito is with the Clinical and Translational Science Institute, Wake Forest University School of Medicine. Benjamin D. Smart is with the Karolinska Institutet, Stockholm, Sweden. Beth A. Reboussin is with the Department of Biostatistics and Data Sciences, Wake Forest University School of Medicine.
Abstract:
Objectives. To evaluate Chicas Creando Acceso a la Salud (Girls Creating Access to Health; ChiCAS), a Spanish-language, small-group intervention designed to increase preexposure prophylaxis (PrEP) use, consistent condom use, and medically supervised gender-affirming hormone therapy use among Spanish-speaking transgender Latinas who have sex with men. Methods. Participants were 144 HIV-negative Spanish-speaking transgender Latinas, aged 18 to 59 years, living in North and South Carolina. From July 2019 to July 2021, we screened, recruited, and randomized them to the 2-session ChiCAS intervention or the delayed-intervention waitlist control. Participants completed assessments at baseline and 6-month follow-up. Follow-up retention was 94.4%. Results. At follow-up, relative to control participants, ChiCAS participants reported increased PrEP use (adjusted odds ratio [AOR] = 4.64; 95% confidence interval [CI] = 1.57, 13.7; P < .006). However, ChiCAS participants did not report increased use of condoms or medically supervised gender-affirming hormone therapy. ChiCAS participants reported increases in knowledge of HIV (P < .001), sexually transmitted infections (P < .001), and gender-affirming hormone therapy (P = .01); PrEP awareness (P < .001), knowledge (P < .001), and readiness (P < .001); condom use skills (P < .001); and community attachment (P < .001). Conclusions. The ChiCAS intervention was efficacious in increasing PrEP use among Spanish-speaking, transgender Latinas in this trial. (Am J Public Health. 2024;114(1):68-78. https://doi.org/10.2105/AJPH.2023.307444).
