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High Rates of PrEP Eligibility but Low Rates of PrEP Access Among a National Sample of Transmasculine Individuals

Golub, Sarit A. PhD, MPHa,b,c; Fikslin, Rachel A. BAa,b,c; Starbuck, Lila MPHa,c; Klein, Augustus PhDa,c

JAIDS Journal of Acquired Immune Deficiency Syndromes: September 1, 2019 - Volume 82 - Issue 1 - p e1–e7
doi: 10.1097/QAI.0000000000002116
Prevention Research

Background: Transmasculine individuals have been largely ignored in HIV prevention research, and there is a lack of data regarding this population's eligibility for and utilization of HIV pre-exposure prophylaxis (PrEP).

Setting: National online survey conducted in the United States.

Methods: Between May and July 2017, we surveyed 1808 transmasculine individuals (aged 18–60 years; 30% people of color and/or Latinx), asking questions about sexual behavior and receipt of sexual health care, including PrEP. We examined the number of individuals who would meet eligibility criteria for PrEP and then used log-linked Poisson regression with robust variance estimation to examine predictors of PrEP eligibility.

Results: Almost one-quarter of the sample (n = 439; 24.3%) met one or more criterion for PrEP eligibility. PrEP eligibility did not differ by age, race/ethnicity, education, or binary gender identity. PrEP eligibility was lower among heterosexual-identified and higher income participants, and was higher among participants who were in open relationships and reported substance use. Among PrEP-eligible individuals, 64.9% had received an HIV test in the past year, 33.9% had received PrEP information from a provider, and 10.9% (n = 48) had received a PrEP prescription. PrEP-eligible individuals who had received a PrEP prescription were more likely to have a binary gender identity, identify as gay, and be taking testosterone.

Conclusions: A substantial proportion of transmasculine individuals meet PrEP eligibility criteria, but few are receiving adequate PrEP services. Enhanced efforts should be made by providers, programs, and systems to assess HIV-related risk in transmasculine patients and engage them in comprehensive sexual health care.

aDepartment of Psychology, Hunter College of the City University of New York, New York, NY;

bBasic and Applied Social Psychology (BASP) PhD Program, Department of Psychology, Graduate Center of the City University of New York, New York, NY; and

cHunter Alliance for Research and Translation (HART), New York, NY.

Correspondence to: Sarit A. Golub, PhD, MPH, Department of Psychology, Hunter College and Graduate Center of the City University of New York (CUNY), 695 Park Avenue, New York, NY 10065 (e-mail:

Supported by Grant R01AA022067-04S1 from the National Institute of Alcohol Abuse and Alcoholism (S.A.G., PI).

The authors have conflicts of interest to disclose.

Received January 08, 2019

Accepted April 26, 2019

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