Starting this year, trans women in San Francisco, Houston, New York City, Philadelphia and Rio de Janeiro will have a new option when looking to combine HIV prevention with gender-affirming care, according to a press release from University of Texas Health (UTHealth).

That’s because the HIV Prevention Trials Network (HPTN) has launched a five-site study looking more deeply at whether providing gender-affirming hormone therapy at the same clinic as HIV pre-exposure prophylaxis (PrEP) plus additional health care navigation services improves trans women’s use of PrEP and reduces HIV rates.

Transgender women, especially Black trans women, have among the highest rates of HIV in the United States. But clinics and health departments have not been good at serving trans women who want to try PrEP. One study found that Black transgender adults were 18% less likely to be engaged in HIV partner services to help their partners receive PrEP if needed. And a lack of gender-appropriate services makes it less likely that a woman of trans experience would engage in HIV prevention and care. The University of California, San Francisco has been engaged in demonstration projects linking HIV prevention services to gender-affirming care for several years.

But this new initiative, HPTN 091, is a separate project seeking to test a similar premise. The trial plans to recruit 310 women of trans experience who are not currently living with HIV. They will be randomly assigned to two different arms. In one, women will receive enhanced care, which includes sexually transmitted infection (STI) screening and treatment, access to Truvada (tenofovir disoproxil fumarate/emtricitabine) or Descovy (tenofovir alafenamide/emtricitabine) PrEP, on-site gender-affirming hormone services and on-site peer navigation services at their first appointment.

The other arm will receive traditional care for six months: PrEP, STI screening and treatment and referral to gender-affirming hormone treatment and case management services, but the clinic wouldn’t offer those services itself. The randomization will last for the first six months of the 18-month study. After that, all women will receive gender-affirming care and peer navigation support on-site.

“This study gives many transgender people who face stigma, discrimination, social rejection and exclusion a way to access health care, employment and HIV prevention services among other resources that are available,” said Byancha Lawson, one of the peer health navigators at Houston’s Thomas Street Health Center.

Click here to read the full press release.

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