{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:44:51Z","timestamp":1790963091101,"version":"4.1.0"},"reference-count":63,"publisher":"Wiley","issue":"S5","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The HIV epidemic continues to disproportionately impact Latin\u2010American transgender women (TGW). We assessed factors associated with long\u2010term pre\u2010exposure prophylaxis (PrEP) engagement and adherence among TGW enrolled in the Implementation of PrEP (ImPrEP) study, the largest PrEP demonstration study in Latin America.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HIV\u2010negative TGW aged \u226518 years reporting 1+eligibility criteria in the 6 months prior to enrolment (e.g. sex partner known to be living with HIV, condomless anal sex [CAS], transactional sex or having a sexually transmitted infection [STI]) who could safely take PrEP were enrolled. Follow\u2010up visits were conducted at 4 weeks and then quarterly. We conducted logistic regression to identify factors associated with long\u2010term PrEP engagement (3+ follow\u2010up visits in 52 weeks) and complete self\u2010reported adherence (no missed pills in the past 30 days) during follow\u2010up. For both outcomes, we constructed multivariable models controlling for country, socio\u2010demographics, sexual behaviour, substance use, STIs and self\u2010reported adherence at 4 weeks (long\u2010term engagement outcome only).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From March 2018 to June 2021, ImPrEP screened 519 TGW, enrolled 494 (Brazil: 190, Mexico: 66 and Peru: 238) and followed them for 52 weeks. At baseline, 27.5% of TGW were aged 18\u201324 years, 67.8% were mixed\u2010race and 31.6% had &gt;secondary education. Most, 89.9% reported CAS, 61.9% had &gt;10 sex partners and 71.9% reported transactional sex. HIV incidence was 1.82 cases per 100 person\u2010years (95% confidence interval [CI]: 0.76\u20134.38). Almost half of TGW (48.6%) had long\u2010term PrEP engagement, which was positively associated with reporting complete adherence at week 4 (aOR:2.94 [95%CI:1.88\u20134.63]) and was inversely associated with reporting CAS with unknown\u2010HIV partner (aOR:0.52 [95%CI:0.34\u20130.81]), migration (aOR:0.54 [95%CI:0.34\u20130.84]), and being from Mexico (aOR:0.28 [95%CI:0.14\u20130.53]). Self\u2010reported adherence was associated with TGW aged &gt;34 (aOR:1.61 [95%CI:1.10\u20132.34]) compared to those aged 25\u201334 and those with &gt;secondary education (aOR:1.55 [95%CI:1.10\u20132.19]) and was lower among TGW from Peru (aOR:0.29 [95%CI:0.21\u20130.41]) or reporting PrEP\u2010related adverse effects (aOR:0.63 [95%CI:0.42\u20130.92]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although TGW were willing to enrol in ImPrEP, long\u2010term PrEP engagement and complete self\u2010reported adherence were limited, and HIV incidence remained relatively high. A successful HIV prevention agenda should include trans\u2010specific interventions supporting oral PrEP and exploring long\u2010acting PrEP strategies for TGW.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25974","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T05:50:27Z","timestamp":1665640227000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Factors associated with long\u2010term HIV pre\u2010exposure prophylaxis engagement and adherence among transgender women in Brazil, Mexico and Peru: results from the ImPrEP study"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2836-0174","authenticated-orcid":false,"given":"Kelika A.","family":"Konda","sequence":"first","affiliation":[{"name":"Universidad Peruana Cayetano Heredia, Centro de Investigaciones Interdisciplinaria en Salud, Sexualidad, y SIDA Lima 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