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Factors associated with PrEP uptake among adolescent´s men who have sex with men and transgender women in Brazil

Title
Factors associated with PrEP uptake among adolescent´s men who have sex with men and transgender women in Brazil
Presenter
Fabiane Soares
Authors
F. Soares * (1), L. Magno (2), M. Eustorgio Filho (1), F.M. Duarte (1), P. Caires (1), A. Grangeiro (3), P. Massa (3), D. Greco (4), U. Tupinambás (4), I. Dourado (1).
Institutions
(1) Federal University of Bahia, Institute of Collective Health, Salvador, Brazil, (2) State University of Bahia, Department of Life Sciences, Salvador, Brazil, (3) University of São Paulo, Department of Preventive Medicine, São Paulo, Brazil, (4) Federal University of Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil

BACKGROUND: HIV prevalence among adolescents' key-population (AKP) of men who have sex with men (MSM) and transgender women (TGW) is disproportionally high. PrEP is an important prevention technology but there are still few studies about PrEP uptake among AKP. We aimed to analyze factors associated with PrEP uptake among AKP in Brazil.
METHODS: Baseline data from the first demonstration PrEP cohort study among AKP 15-19 years old ongoing in three large Brazilian cities (PrEP1519). Participants were enrolled in the cohort between March/2019-December 2020. A socio-behavioral questionnaire was applied and multivariate analyses were performed using logistic regression with adjusted odds ratio (aOR) and 95% confidence intervals (95%CI) estimation.
RESULTS: The majority of the 756 AKP participants were MSM (92.6%), black or mixed-race (68.5%), aged 18-19 years old (80.3%), with 12 or more years of schooling (51.2%). A third of the adolescents reported an experience of violence and/or discrimination due to their sexual orientation or gender identity (32.4%). Self-perception of risk for HIV was classified as low (34.0%), medium (46.4%), and high (19.6%). The prevalence of PrEP uptake was 87.2%, and it was significantly higher among TGW, compared with MSM (98.2% and 86.3%, respectively, p-value=0.01). Factors associated with PrEP uptake were self-perception of high risk for HIV (OR 2.24; 95%CI: 1.10-4.58) and experience of violence and/or discrimination due to their sexual orientation or gender identity (OR 2.00; 95%CI: 1.14-3.51).
CONCLUSIONS: Study findings reveal a high proportion of PrEP uptake and important socio/behavior/contextual data to target AKP who may be more or less willing to use PrEP, improving provider communication about PrEP and HIV risk, and creating culturally and developmentally appropriate PrEP demand creation materials for AKP.