Awareness, accessibility and uptake of pre-exposure prophylaxis (PrEP) among cisgender and transgender women at risk of HIV infection

Key take-home messages

• Women at risk of HIV are underrepresented in PrEP research. Despite women’s increased willingness and interest in taking PrEP, there is low awareness and uptake of PrEP. Research has identified various reasons why women at risk may decline PrEP, such as considering themselves to be at a low-risk of acquiring HIV, or concerns about PrEP side effects.  
• The use of mobile technology and social media has been shown to improve PrEP awareness and increase PrEP knowledge among Black and transgender women.
• Improved access to PrEP can be achieved through the implementation of interventions targeting specific populations of women at risk of acquiring HIV. Examples include providing PrEP access through pairing screening and treatment of sexually transmitted infections (STIs) with mobile syringe exchange programs for women who inject drugs, and ensuring inclusion of PrEP services in gender-affirming programs for transgender women.
• Access to inclusive, non-stigmatizing, affordable PrEP resources, as well as the understanding of one’s individual HIV risk and the benefits of PrEP, could be major facilitators of PrEP uptake.
• Limited PrEP awareness and understanding of one’s HIV risk, concerns about side effects, stigma, and cost are common barriers impacting PrEP uptake.
• Increasing awareness, accessibility, and uptake of PrEP among transgender women requires innovative and inclusive approaches that address their unique needs and social realities, such as complementary health priorities (e.g., hormone therapy, need of gender-affirming care and services), and social and structural factors (e.g., stigma, transphobia, discrimination).

• Population(s)
  • Women
  • Transgender communities
  • General HIV- population
• Prevention, Engagement and Care Cascade
  • Prevention
• Prevention
  • Biomedical interventions