{
  "abstract": "Background While HIV-PrEP scale-up has expanded in several settings, key-populations at ongoing risk, particularly women, remain underrepresented among PrEP users.The limited clinical and epidemiological data available on cisgender and transgender women (CW/TW) underscores persistent structural, stigma and gender-related barriers to access and continuity of care.In the context of the ICONA PrIDE cohort, comparative analyses of CW/TW vs gay and bisexual men who have sex with men (GBMSM) may clarify behavioral and stigma related determinants of PrEP use.Methods We conducted an analysis within the PrIDE cohort including CW/TW initiating PrEP, matched 1:2 with GBMSM using nearest-neighbor propensity score matching adjusting for age, education, employment, and relationship status. We compared demographics, lifestyle habits, sexually transmitted infections (STI) history, HIV post-exposure prophylaxis (PEP) experience, PrEP schedule, and responses to questionnaires on sexual behaviors, and stigma. Categorical variables were compared using chi-square or Fisher’s exact test, and continuous variables using Wilcoxon rank-sum test.Results Among 219 matched participants (68 CW, 5 TW and 146 GBMSM), baseline characteristics were comparable ( table 1). CW/TW were more likely to initiate daily rather than on-demand regimens (58.9% vs 39.7%, p<0.001), consistent with recently extended recommendations regarding on-demand PrEP use in CW. Knowledge of DoxyPEP was lower among CW/TW (27.4% vs 43.2%, p=0.036), whereas no differences were observed in previous PEP experience. No differences emerged in tobacco, alcohol, drugs, or physical enhancers use.Regarding questionnaire, CW/TW more frequently reported receptive condomless intercourse in the last three months (19.2% vs 13.0%, p=0.033) and sharing of sex toys with partners (8.2% vs 4.7%, p=0.024). Sexual behaviors were similar, with no differences in number of partners (16.4% vs 23.3%, p=0.089), history of condomless intercourse (p=0.144), or chemsex use (p=0.625). However, GBMSM more frequently reported a diagnosis of at least one STI (62.3% vs 47.9%, p=0.005). Both groups reported high confidence in correct adherence, minimal changes in sexual habits after PrEP initiation, and low interference of PrEP with daily life. No differences were observed in reduction of condom use (p=0.788) or group sex (p=0.706).Following an STI diagnosis, GBMSM more frequently reported feelings of stigma (9.6% vs 0%, p=0.003), whereas no differences were found in stigma related to PrEP use (1.4% vs 1.4%, p=0.583). Similarly, no differences emerged in self-reported depressive (2.7% vs 0%, p=0.414) or anxiety symptoms (1.4% vs 0.7%, p>0.999).Conclusions CW/TW demonstrated behavioral risk profiles comparable to GBMSM. This suggests that engagement strategies and educational policies should be implemented in order to ensure CW/TW can access to equitable, tailored, and gender-aligned PrEP services.Abstract OC28 Table 1General characteristics",
  "authors": [
    {
      "affiliations": [
        "National Institute Lazzaro Spallanzani IRCCS, Rome, Italy"
      ],
      "name": "G Micheli"
    },
    {
      "affiliations": [
        "National Institute Lazzaro Spallanzani IRCCS, Rome, Italy"
      ],
      "name": "D Farinacci"
    },
    {
      "affiliations": [
        "IRCCS Ospedale San Raffaele, Infectious Diseases Unit, Milan, Italy"
      ],
      "name": "R Lolatto"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, Milan, Italy"
      ],
      "name": "C Fusetti"
    },
    {
      "affiliations": [
        "Milano Checkpoint, Milano, Italy"
      ],
      "name": "E Caruso"
    },
    {
      "affiliations": [
        "Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy"
      ],
      "name": "E Bruzzesi"
    },
    {
      "affiliations": [
        "Amedeo di Savoia Hospital, Unit of Infectious Diseases, Turin, Italy"
      ],
      "name": "A Lucchini"
    },
    {
      "affiliations": [
        "Infectious Diseases Unit, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy"
      ],
      "name": "D Tesoro"
    },
    {
      "affiliations": [
        "Infectious Diseases, San Martino Hospital Genoa, University of Genoa, Genoa, Italy"
      ],
      "name": "L Taramasso"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, School of Medicine and Surgery, Milan, Italy"
      ],
      "name": "A Raimondi"
    },
    {
      "affiliations": [
        "Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy"
      ],
      "name": "AM Cattelan"
    },
    {
      "affiliations": [
        "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, Polyclinic of Bari, University Hospital Polyclinic, University of Bari, Bari, Italy"
      ],
      "name": "E Milano"
    },
    {
      "affiliations": [
        "Department of Clinical Medicine and Surgery, Infectious Diseases Unit, University of Naples Federico II, Naples, Italy"
      ],
      "name": "E Zappulo"
    },
    {
      "affiliations": [
        "Infectious Diseases Unit, ASST Lecco, Lecco, Italy"
      ],
      "name": "F Conti"
    },
    {
      "affiliations": [
        "Infectious Diseases Unit, ASST Papa Giovanni XXIII, Bergamo, Italy"
      ],
      "name": "S Venturelli"
    },
    {
      "affiliations": [
        "Infectious Diseases Unit, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy"
      ],
      "name": "A De Bona"
    },
    {
      "affiliations": [
        "National Institute Lazzaro Spallanzani IRCCS, Rome, Italy"
      ],
      "name": "A Antinori"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, Milan, Italy"
      ],
      "name": "D Moschese"
    },
    {
      "affiliations": [
        "IRCCS Ospedale San Raffaele, Infectious Diseases Unit, Milan, Italy"
      ],
      "name": "S Nozza"
    },
    {
      "affiliations": [
        "National Institute Lazzaro Spallanzani IRCCS, Rome, Italy"
      ],
      "name": "V Mazzotta"
    }
  ],
  "title": "OC28 Characteristics of cisgender and transgender women in PrIDE cohort, risk behaviours and stigma",
  "uid": "4fbc219d-750b-56a3-8963-de3c79d2c290"
}