Adherence to Pre-exposure Prophylaxis intervention by transgender women: A systematic review

Background The prevalence of HIV is higher in the transgender population. Recently, the preexposure prophylaxis (PrEP) intervention has been proven successful in reducing HIV acquisition in trials among men who have sex with men (MSM), and heterosexual couples. This research aims to investigate the adherence to PrEP by HIV-negative transgender women (TW). Methods Were followed the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA Statement. Research in WoS, Ovid, Scopus, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases for studies that involved HIV-negative TW population and focused on their adherence to PrEP intervention and condom use after the treatment. Results 11 studies were included. TW sample sizes were low in comparison to the total sample, which often included men who have sex with men (MSM) population. The participation and adherence to the intervention was low compared to MSM, and it was measured mainly by self-report (72.7%) or by Tenofovir-diphosphate (TFV-DP)/ Emtricitabine triphosphate (FTC-TP) dried blood spot (DBS) (45.5%). Conclusions It is important to increase awareness and explain the effect of PrEP on feminizing hormone therapy at the beginning of the trials. Nevertheless, the low adherence may be affected by the interaction between drugs and the barriers faced to use the health services.