Use of biomedical HIV prevention methods among cis and trans women:

a bibliographic PrEP-based essay

Abstract

Pre-exposure prophylaxis (PrEP) is a biomedical prevention method available in the Brazilian Unified Health System (SUS) that consists of the oral use of antiretroviral drugs to reduce the risk of HIV transmission. Currently, its use is not restricted to “key populations,” and it can be indicated for people aged 15 and older, weighing 35 kg or more, and in a context of vulnerability to infection. Over the years, normative documents have included men who have sex with men, serodiscordant couples, transgender people, transvestites, and sex workers in these classifications. Considering these variations, this bibliographic essay seeks to understand and problematize how cisgender and transgender women have known, accessed, and used this prevention method. To this end, a literature review was conducted using national and international qualitative articles, as well as Brazilian dissertations and theses. The available research shows that low or no PrEP use by cisgender women is related to factors such as low perceived risk of HIV, lack of knowledge of serologic partner status, partner violence, lack of information and access, as well as structural factors such as racism and gender oppression. Transgender women face access challenges, mainly related to stigma and discrimination. We also observed underrepresentation of this group in scientific production compared to men. We consider that social markers such as race, class, generation, gender, and sexuality influence the knowledge, access, and use of PrEP, for both cisgender and transgender women.

Keywords: Pre-exposure prophylaxis. HIV/AIDS. Prevention. Cisgender women. Transgender women.