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Transgender Women’s Experiences Using a Home HIV-Testing Kit for Partner-Testing

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Abstract

HIV partner-testing (PT) may represent a unique and empowering HIV prevention strategy for groups that face structural and institutional barriers to HIV testing and care, including transgender women. We report on in-depth interviews (IDIs) with N = 10 transgender women who used HIV self-test kits for three months to screen potential sexual partners in a randomized controlled trial (iSUM; “I’ll Show You Mine”) that took place in New York City and San Juan, Puerto Rico. Participants were assigned to intervention (supplied with 10 self-test kits immediately) or control groups (received 6 test kits after 3 months). We conducted IDIs with the first N = 10 transgender women to enroll in the intervention group after three months in the study (after participants used kits with partners) to understand their experiences. Themes discussed in IDIs included: partners’ reaction to HIV testing, participants’ reactions to partners’ test results or refusal to test, partners’ own reaction to their test results, and decision-making around test use. Data were independently analyzed by two coders. Overwhelmingly, participants’ experiences with PT was positive. Participants reported kits were convenient and acceptable to most partners. Transgender women felt that PT could pose additional risk for them; one woman experienced violence related to kit use. Furthermore, the availability of kits appeared to encourage participants and their partners to think about their HIV status and, in some cases, modify sexual behavior. Work suggests that HIV PT could be a viable risk-reduction strategy for transgender women.

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References

  1. Krause J, Subklew-Sehume F, Kenyon C, Colebunders R. Acceptability of HIV self-testing: a systematic literature review. BMC Public Health. 2013;13:735.

    Article  Google Scholar 

  2. Lippman SA, Moran L, Sevelius J, Castillo LS, Ventura A, Treves-Kagan S, Buchbinder S. Acceptability and feasibility of HIV self-testing among transgender women in San Francisco: a mixed methods pilot study. AIDS Behav. 2016;20:928–38.

    Article  Google Scholar 

  3. Carballo-Dieguez A, Frasca T, Balan I, Ibitoye M, Dolezal C. Use of a rapid HIV home test prevents HIV exposure in a high risk sample of men who have sex with men. AIDS Behav. 2012;16:1753–60.

    Article  Google Scholar 

  4. Baral SD, Poteat T, Stromdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13:214–22.

    Article  Google Scholar 

  5. WHO. Consolidated guidelines on HIV prevention, diagnosism treatment and care for key populations. Geneva: World Health Organization; 2014.

    Google Scholar 

  6. Safer JD, Coleman E, Feldman J, Garofalo R, Hembree W, Radix A, Sevelius J. Barriers to healthcare for transgender individuals. Curr Opin Endocrinol Diabetes Obes. 2016;23:168–71.

    Article  Google Scholar 

  7. Deutsch MB, Glidden DV, Sevelius J, Keatley J, McMahan V, Guanira J, Kallas EG, Chariyalertsak S, Grant RM. HIV pre-exposure prophylaxis in transgender women: a subgroup analysis of the iPrEx trial. Lancet HIV. 2015;2:e512–e519519.

    Article  Google Scholar 

  8. Rael CT, Martinez M, Giguere R, Bockting WO, MacCrate C, Mellman W, Valente P, Greene GJ, Sherman S, Footer K, D'Aquila RT, Carballo-Diéguez A. Barriers and facilitators to oral PrEP use among transgender women in New York City. AIDS Behav. 2018;22:3627–36.

    Article  Google Scholar 

  9. Thirumurthy H, Masters SH, Mavedzenge SN, Maman S, Omanga E, Agot K. Promoting male partner HIV testing and safer sexual decision making through secondary distribution of self-tests by HIV-negative female sex workers and women receiving antenatal and post-partum care in Kenya: a cohort study. The Lancet HIV. 2016;3:e266–e274274.

    Article  Google Scholar 

  10. Weller SC, Vickers B, Bernard HR, Blackburn AM, Borgatti S, Gravlee CC, Johnson JC. Open-ended interview questions and saturation. PLoS ONE. 2018;13:e0198606.

    Article  Google Scholar 

  11. Iribarren SJ, Ghazzawi A, Sheinfil AZ, Frasca T, Brown W 3rd, Lopez-Rios J, Rael CT, Balan IC, Crespo R, Dolezal C, Giguere R, Carballo-Dieguez A. Mixed-method evaluation of social media-based tools and traditional strategies to recruit high-risk and hard-to-reach populations into an HIV prevention intervention Study. AIDS Behav. 2018;22:347–57.

    Article  Google Scholar 

  12. Brown W, Sheinfil A, Lopez-Rios J, Giguere R, Dolezal C, Frasca T, Lentz C, Balan I, Rael CT, Cruz-Torres C, Crespo R, Febo I, Carballo-Diéguez A. Methods, system errors, and demographic differences in participant errors using daily text message-based short message service computer-assisted self-interviews (SMS-CASI) to measure sexual risk behavior in an RCT of HIV self-test use. Health. 2019. https://doi.org/10.21037/mhealth.2019.06.01.

    Article  PubMed  Google Scholar 

  13. Saldaña J. The coding manual for qualitative researchers. 2nd ed. London: Sage; 2013.

    Google Scholar 

  14. Greene JA, Thorogood N. Qualitative methods for health research. 3rd ed. London: Sage; 2014.

    Google Scholar 

  15. Thomas DR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval. 2006;27:237–46.

    Article  Google Scholar 

  16. Masters SH, Agot K, Obonyo B, Napierala Mavedzenge S, Maman S, Thirumurthy H. Promoting partner testing and couples testing through secondary distribution of HIV self-tests: a randomized clinical trial. PLoS Med. 2016;13:e1002166.

    Article  Google Scholar 

  17. Maman S, Murray KR, Napierala Mavedzenge S, Oluoch L, Sijenje F, Agot K, Thirumurthy H. A qualitative study of secondary distribution of HIV self-test kits by female sex workers in Kenya. PLoS ONE. 2017;12:e0174629.

    Article  Google Scholar 

  18. Giguere R, Lopez-Rios J, Frasca T, Lentz C, Balan IC, Dolezal C, Rael CT, Brown W, Sheinfil AZ, Cruz Torres C, Crespo R, Febo I, Carballo-Dieguez A. Use of HIV Self-testing kits to screen clients among transgender female sex workers in New York and Puerto Rico. AIDS Behav. 2020;24:506–15.

    Article  Google Scholar 

  19. Carballo-Dieguez A, Frasca T, Dolezal C, Balan I. Will gay and bisexually active men at high risk of infection use over-the-counter rapid HIV tests to screen sexual partners? J Sex Res. 2012;49:379–87.

    Article  Google Scholar 

  20. Carballo-Diéguez A, Giguere R, Balán IC, Brown W, Dolezal C, Leu CS, Lopez-Rios J, Sheinfil A, Frasca T, Rael CT, Lentz C, Crespo R, Iribarren SJ, Cruz-Torres C, Febo I. Use of rapid HIV self-test to screen potential sexual partners: Results of the ISUM study. AIDS Behav. 2020. https://doi.org/10.1007/s10461-020-02809-1.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Matovu JK, Buregyeya E, Arinaitwe J, Wanyenze RK. ‘… If you bring the kit home, you [can] get time and test together with your partner': pregnant women and male partners' perceptions regarding female partner-delivered HIV self-testing in Uganda: a qualitative study. Int J STD AIDS. 2017;28:1341–7.

    Article  Google Scholar 

  22. Ventuneac A, Carballo-Dieguez A, Leu CS, Levin B, Bauermeister J, Woodman-Maynard E, Giguere R. Use of a rapid HIV home test to screen sexual partners: an evaluation of its possible use and relative risk. AIDS Behav. 2009;13:731–7.

    Article  Google Scholar 

  23. Leu CS, Ventuneac A, Levin B, Carballo-Dieguez A. Use of a rapid HIV home test to screen sexual partners: a commentary on Ventuneac, Carballo-Dieguez, Leu et al. 2009. AIDS Behav. 2012;16:1–4.

    Article  Google Scholar 

  24. Kumwenda MK, Johnson CC, Choko AT, Lora W, Sibande W, Sakala D, Indravudh P, Chilongosi R, Baggaley RC, Nyirenda R, Taegtmeyer M, Hatzold K, Desmond N, Corbett EL. Exploring social harms during distribution of HIV self-testing kits using mixed-methods approaches in Malawi. J Int AIDS Soc. 2019;22(Suppl 1):e25251.

    Article  Google Scholar 

  25. Logie CH, James L, Tharao W, Loutfy MR. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada. PLoS Med. 2011;8:e1001124.

    Article  Google Scholar 

  26. Asiedu GB, Myers-Bowman KS. Gender differences in the experiences of HIV/AIDS-related stigma: a qualitative study in Ghana. Health Care Women Int. 2014;35:703–27.

    Article  Google Scholar 

Download references

Acknowledgements

The authors wish to thank the participants who shared their time and thoughts about using PT kits with potential sexual partners. Research was supported by a grant from NICHD (R01 AI113127; PI: Alex Carballo-Diéguez) and from the National Institute of Mental Health at the HIV Center for Clinical and Behavioral Studies at the NY State Psychiatric Institute and Columbia University (P30 MH43520; Center PI: Robert Remien, Ph.D.). The first author is supported by a K01 Award (K01 MH115785; PI: Christine Tagliaferri Rael, Ph.D.). William Brown III was supported by the National Library of Medicine (NLM) [grant numbers R01- LM012355 PI: Schillinger, T15-LM007079 PI: Hripcsak, R01-LM013045 PI: Lyles], the National Institute on Minority Health and Health Disparities (NIMHD) [grant number P60-MD006902 PI: Bibbins-Domingo], the Agency for Healthcare Research and Quality (AHRQ) [grant number K12-HS026383], and the National Center for Advancing Translational Sciences (NCATS) of the NIH [UCSF-CTSI grant number KL2-TR001870] during various stages of the research and/or preparation of the article … The content is solely the responsibility of the authors and does not necessarily represent the official views of NICHD, NIMH, NLM, NIMHD, AHRQ, NCATS, or the NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. The research team would like to thank all participants.

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Authors and Affiliations

  1. HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Dr, New York, NY, 10032, USA

    Christine Tagliaferri Rael, Rebecca Giguere, Javier Lopez-Rios, Cody Lentz, Iván C. Balán, Curtis Dolezal, William Brown III, Timothy Frasca, Cheng-Shiun Leu & Alex Carballo-Diéguez

  2. Department of Psychology, Syracuse University, Syracuse, NY, USA

    Alan Sheinfil

  3. Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA

    William Brown III

  4. Division of General Internal Medicine, Department of Medicine, School of Medicine, Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, CA, USA

    William Brown III & Raynier Crespo

  5. Baker Computational Health Science Institute, University of California San Francisco, San Francisco, CA, USA

    William Brown III

  6. Department of Pediatrics, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, USA

    Catherine Cruz Torres & Irma Febo

  7. School of Nursing, University of Washington, Seattle, WA, USA

    Sarah Iribarren

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  1. Christine Tagliaferri Rael
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  2. Rebecca Giguere
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  3. Javier Lopez-Rios
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  4. Cody Lentz
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  10. Catherine Cruz Torres
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  15. Alex Carballo-Diéguez
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Correspondence to Christine Tagliaferri Rael.

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Rael, C.T., Giguere, R., Lopez-Rios, J. et al. Transgender Women’s Experiences Using a Home HIV-Testing Kit for Partner-Testing. AIDS Behav 24, 2732–2741 (2020). https://doi.org/10.1007/s10461-020-02829-x

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