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Sexually Transmitted Infections

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Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...

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Oral PrEP Use by Transgender Men in Uganda: A Multi-method Evaluation.

Andrew Mujugira^1,2,3, Vicent Kasiita⁴, Monica Bagaya⁴

¹Infectious Diseases Institute, Makerere University, P. O Box 22418, Kampala, Uganda. amujugira@idi.co.ug.

AIDS and Behavior

|November 12, 2025

Summary

This study on HIV pre-exposure prophylaxis (PrEP) in sub-Saharan African transgender men found moderate uptake and adherence. Integrating HIV prevention with sexual and mental healthcare is crucial for this population.

Keywords:

Africa HIV Pre-exposure prophylaxis Sexually transmitted infections Transgender men Urine tenofovir test

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Area of Science:

Global Health
Public Health
Transgender Health

Background:

HIV pre-exposure prophylaxis (PrEP) use remains understudied in transgender men within sub-Saharan Africa.
Understanding PrEP adherence and associated factors is critical for effective HIV prevention strategies in this key population.

Purpose of the Study:

To assess PrEP uptake, adherence, and related factors among transgender men in sub-Saharan Africa.
To explore the lived experiences influencing PrEP use and adherence in this demographic.

Main Methods:

A prospective cohort study enrolled 75 transgender men, followed for 12 months with social media recruitment.
In-depth interviews and point-of-care urine tenofovir assays were used to assess knowledge, testing, service access, and adherence.
Inductive content analysis was applied to qualitative data.

Main Results:

The study observed a 48% PrEP uptake and moderate adherence, with urine tenofovir positivity increasing over time.
Key themes included societal rejection, economic exclusion, challenges with adherence, and the role of urine testing in facilitating conversations.
Low HIV/STI prevalence (HBV, HIV, syphilis, chlamydia, trichomonas) was noted.

Conclusions:

Competing priorities significantly impacted PrEP adherence among transgender men in sub-Saharan Africa.
This study highlights the need for integrated HIV prevention, sexual healthcare, and mental health services for this population.
Tailored interventions addressing social and economic factors are essential to improve PrEP adherence.