HIV Pre-Exposure Prophylaxis in Transgender Women: A Subgroup Analysis of the iPrEx Trial

In the subgroup analysis of the iPrEx trial with 2,499 participants, 339 (14%) were transgender women. The study aimed to assess the efficacy and adherence of HIV pre-exposure prophylaxis (PrEP) in this group. Results showed that transgender women had lower PrEP drug exposure and adherence, particularly those at higher risk for HIV. There were 11 HIV infections in the PrEP group and 10 in the placebo group among transgender women, indicating no significant difference in infection rates. The study concluded that while PrEP can be effective for transgender women, adherence is a significant challenge. It also highlighted the need for more research on the interactions between feminizing hormones and PrEP medications and the integration of PrEP with gender-affirming services.