{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:36:31Z","timestamp":1792611391776,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T00:00:00Z","timestamp":1593475200000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"crossref","award":["P30MH062246"],"award-info":[{"award-number":["P30MH062246"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Although transgender women (trans women) often are conflated with\u00a0men who have sex with men\u00a0 (MSM) in HIV research and services, there are distinct population\u00a0differences that are important\u00a0for implementing effective HIV prevention. Our objective was to examine pre\u2010exposure prophylaxis (PrEP) disparities between the two populations and compare individual, social and structural factors that influence differences between MSM and trans women along the PrEP continuum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed data from two population\u2010based studies, one with trans women (Trans*National Study, 2016 \u2010 18) and the other with MSM (National HIV Behavioral Surveillance, 2017). Trans women were recruited via respondent\u2010driven sampling and MSM using time location sampling. Key indicators of the PrEP continuum were evaluated, including awareness, health insurance, provider discussions, recent use and adherence. Associations were also examined for PrEP continuum indicators and structural barriers (e.g. employment, homelessness).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Transwomen were more likely than MSM to be Latino\/a (30.4% vs. 25.8%; prevalence ratio (PR)=1.08, 95% CI 1.02 to 1.14) or African American (7.1% vs. 4.5%; PR\u00a0=\u00a01.12, 1.02 to 1.24), live at or below the poverty limit (70.7% vs. 15.8%; PR\u00a0=\u00a01.47; 1.41 to 1.53), be unemployed (50.1% vs. 26.3%; PR\u00a0=\u00a01.18, 1.13 to 1.24), be homeless (8.4% vs. 3.5%; PR\u00a0=\u00a01.15, 1.06 to 1.25) and\u00a0to have less than a college degree (PR\u00a0=\u00a01.41, 1.34 to 1.48). Trans women were more likely than MSM to\u00a0have health insurance (95.7% vs. 89.7%, PR\u00a0=\u00a01.17, 1.06 to 1.28), but less likely than MSM to have heard of PrEP (79.1% vs. 96.7%; PR\u00a0=\u00a00.77, 0.73 to 0.81), talked with a provider about PrEP (35.5% vs. 54.9%; PR\u00a0=\u00a00.87, 0.83 to 0.91) and less likely than MSM to have\u00a0used PrEP in the past six months (14.6% vs. 39.8%; PR\u00a0=\u00a00.80, 0.76 to 0.84). Among PrEP users, trans women were less likely to report being adherent to PrEP than MSM (70.4% vs. 87.4%; PR\u00a0=\u00a00.80, 0.70 to 0.91).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found PrEP disparities for trans women compared to MSM and the need for differentiated implementation strategies to meet the specific PrEP barriers trans women face. Inclusion of trans women\u2019s HIV risks is needed in CDC guidance for PrEP. Interventions to increase trans women\u2019s awareness of PrEP including at the provider and community level are also needed. Finally, programming that addresses trans women\u2019s barriers to housing and income is also needed to reduce PrEP disparities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25539","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T12:09:02Z","timestamp":1593518942000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Disparities in the PrEP continuum for trans women compared to MSM in San Francisco, California: results from population\u2010based cross\u2010sectional behavioural surveillance studies"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0237-495X","authenticated-orcid":false,"given":"Erin C","family":"Wilson","sequence":"first","affiliation":[{"name":"Center for Public Health Research San Francisco Department of Public Health San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin M","family":"Turner","sequence":"additional","affiliation":[{"name":"Center for Public Health Research San Francisco Department of Public Health San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Arayasirikul","sequence":"additional","affiliation":[{"name":"Center for Public Health Research San Francisco Department of Public Health San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marguerita","family":"Lightfoot","sequence":"additional","affiliation":[{"name":"Division of Prevention Science Center for AIDS Prevention Studies University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Scheer","sequence":"additional","affiliation":[{"name":"HIV Epidemiology San Francisco Department of Public Health San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry F","family":"Raymond","sequence":"additional","affiliation":[{"name":"Rutgers University New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Liu","sequence":"additional","affiliation":[{"name":"Bridge HIV San Francisco Department of Public Health San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,30]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"(SFDPH) SFDoPH.HIV semi\u2010annual report December 2018.2018."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002315"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052382"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2013-051342"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-019-02462-3"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-019-02411-0"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2299-7"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2016.1154085"},{"key":"e_1_2_8_10_1","unstructured":"SeveliusJ JohnsonM.A Qualitative Investigation of Barriers to Treatment Initiation and Engagement among Transgender Women Living with HIV. 8th International Conference on HIV Treatment and Prevention Adherence; 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