TOPIC: "Points of intervention along the HIV continuum for transgender women: Considering factors of preexposure prophylaxis (PrEP), substance use, exogenous hormone use and cardiovascular disease (CVD) risk”
SPEAKER: Elena Cyrus, PhD, MPH
WHERE: UAHS COM-T 6120
WHEN: Friday, October 25, 2019 | 11:00 am - 12:00 pm
About the Speaker:
Dr. Elena Cyrus is a postdoctoral Fellow and National Institute on Drug Abuse (NIDA) funded K99 Scholar at Florida International University in Miami, FL. Dr. Cyrus is currently investigating determinants associated with substance use and PrEP initiation among transgender women, and, disparities in the continuum of HIV care for Afro-Caribbean immigrants in Florida. Dr. Cyrus was a Global Health Equity Scholars Global Health Fellow in Lima Peru where she worked on two projects assessing factors that influenced substance use, violence, and sexual behavior among Peruvian men who have sex with men, transgender women, and female prisoners. Prior to her doctoral training, Dr. Cyrus was a clinical research manager for four years with the HIV Prevention Trial Network, where she worked on the HPTN 055 and HPTN 059 tenefovir feasibility and safety trials.
Transgender women (TGW) are a vulnerable marginalized population who are at risk for several co-morbid conditions, of which HIV may be considered one of the most formidable threats with some HIV prevalence estimates ranging 19% – 27%.
Prevention (PreP): In addition to increasing risk behavior, substance use can increase HIV risk and disease progression through physiological mechanisms as well as curtail adherence to treatment regimens, but these issues are understudied among TGW. In response to these scientific gaps, the primary objective of the ongoing TRUST – To Reach Unrestricted services for transgender women – study, uses a two-phase mixed method approach to examine the relationship between substance use, daily use of preexposure prophylaxis (PrEP), and HIV transmission in this population.
Engagement in care (Exogenous hormone use and cardiovascular disease CVD risk): Simultaneously, TGW routinely engage in exogenous hormone use to aid with feminization. Exogenous hormone use and HIV separately, are factors found to increase CVD risk, however this is understudied in transgender populations for whom hormone use and HIV can be prevalent. Therefore, the TRUST ancillary study, which is a retrospective chart review of a clinic-based sample of transitioning adolescents, aims to determine if exogenous hormone use increases CVD risk in TGW over time.
Findings from both studies will help to provide information for patients and providers to consider when selecting and determining preventive HIV biomedical options (i.e. PrEP), and, therapeutic treatment with exogenous hormone use that can exacerbate CVD risk for those living with HIV and among those who are uninfected but at high-risk for HIV transmission.