Practices and preferences for HIV testing and treatment services amongst partners of transgender women in Lima, Peru: An exploratory, mixed methods study

TL;DR

This study explores HIV testing and treatment practices and preferences among partners of transgender women in Lima, Peru, revealing shared needs and areas for improvement in service delivery.

Contribution

The study identifies unmet needs and preferences for HIV services among a hidden population—partners of transgender women—in Peru.

Findings

Partners of transgender women (PTW) and transgender women (TW) share similar HIV service preferences but PTW use fewer non-traditional testing options.

PTW preferences for HIV services vary depending on the nature of their relationship with transgender women.

Participants emphasized the need for efficient, private, and discrimination-free HIV services.

Abstract

In Peru, one-third of transgender women (TW) are estimated to be living with HIV. While TW are recognized as a priority population, their sexual partners are an at-risk hidden population with unmet needs for HIV services. We conducted a study examining the practices and preferences for HIV services among partners of transgender women (PTW), as compared to TW, to better understand the needs of PTW and inform HIV service delivery for them in Peru.

Between July-October 2022 we conducted a cross-sectional mixed methods study among PTW and TW in Lima, Peru. Using an explanatory sequential design, we administered online surveys to PTW (n = 165) and TW (n = 69), then interviewed a subset of participants (n = 20: 16 PTW, 4 TW). We quantitatively and qualitatively described PTW practices/perspectives on HIV testing and treatment and compared them to TW practices/preferences; we also compared practices/preferences among PTW based on their relationship with TW.

Overall, PTW and TW shared similar experiences and preferences for HIV testing/treatment, but fewer PTW reported accessing non-traditional HIV testing options and PTW expressed less strong preferences for HIV services. PTW practices/preferences varied by type of relationship with TWs. Surveys and interviews highlighted a need to prioritize efficiency for HIV testing, eliminate gender/sexuality-based discrimination in healthcare settings, increase privacy when delivering HIV services, and increase awareness of pre-exposure prophylaxis.

PTW identified many aspects related to the location, convenience, and privacy of HIV services as important. Next steps could include a discrete choice experiment to further clarify priorities for HIV services for PTW in Peru.

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