According to a study presented at the AIDS 2022 conference in Montreal, Canada, transgender individuals, especially transgender men (TGM), show poor acceptance of HIV prevention interventions (HPI) in the Philippines. While some transgender people who prefer to have sex with men use HPI, it remains relatively lower among TGM who have sex with men (SM).
“This justifies the non-exclusion of TGM-SM in both biobehavioral surveillance and HIV programs,” said the researchers, led by P. Eustaquio of LoveYourself, Inc., a community of volunteers providing free HIV testing, counseling, treatment and offers life coaching in the Philippines.
“However, TGM-SM remains vulnerable to stigma associated with MSM and being transgender and would benefit from further research into their health concerns,” she added.
In this study, a secondary data analysis was performed using clinical data among TGM and women (TGW) enrolled by LoveYourself in Victoria prior to the 2018 to 2019 pandemic.
The researchers identified the use of HPI, specifically condom, pre- (PrEP) and post-exposure prophylaxis (PEP), and/or HIV testing, through self-reporting. They also developed a multivariate generalized linear model using modified Poisson distribution with robust variance estimator to examine covariates for the use of HPI.
From 2018 to 2019, a total of 465 individuals (median age 25 years) participated in the LoveYourself clinic, including 139 TGW and 326 TGM. About 116 TGW (83.5 percent) and 17 TGM (5.2 percent) reported having sex with men. [AIDS 2022, abstract 3876]
Of the participants, 128 reported using at least one HPI. Condoms (60.1 percent) were the most common HPI, followed by HIV testing (55.5 percent). In contrast, the use of PrEP (0.8 percent) and PEP (0 percent) was negligible.
HPI uptake was higher in TGW than in TGM (adjusted prevalence ratio [aPR]5.11, 95 percent confidence interval [CI]2.89-9.04) and among those who had sexual preference for men versus others (aPR, 4.81, 95 percent CI, 2.67-8.66).
A significant interaction was observed between gender identity and sexual preference (p<0.001). Specifically, TGM-SM showed lower HPI uptake compared to TGW-SM.
“Globally and locally, the health problems of transgender people, especially TGM-SM, have hardly been explored yet,” the researchers said. “This translates into a lack of differentiated approach to service delivery, poor adoption of health interventions and sub-optimal health outcomes.”
Sex Positive Campaign
In another LoveYourself study, JD Rosadiño and colleagues found that a sex-positive community campaign is effective at raising awareness of PrEP. [AIDS 2022, abstract 10284]
Thirteen Twitter alter influencers participated in the campaign, and each of their posts received unique commissions ranging from 3,000 to 70,000, for a total of 239,382 for the entire campaign duration. The total number of impressions made reached a total of 4,478,986. According to the authors, the numbers were organic, with no ads or fund raising.
In addition, the PrEP registration sign-up link was opened 25,000 times and inquiries about PrEP on LoveYourself’s social media channels increased by 3,500 percent. By December 2021, the number of enrollees for the drug had increased by 194 percent.
“Community consultation is essential in creating demand-generating PrEP programs for other key communities,” the authors said.