Network meta-analytical evaluations of the performance of HIV combination prevention strategies for transsexual populations

Résumé fourni par la source

Combination HIV prevention approaches, integrating behavioral, biomedical, and social components, have shown promise but remain under-evaluated in trans-specific contexts. This work aimed to compare the effectiveness of different HIV prevention strategies among transgender populations through a network meta-analysis. A systematic search was conducted through PRISMA-NMA 2020 across PubMed, SciELO, LILACS, and Science Direct (2000-2025) using descriptors related to HIV, combined prevention, and Transgender populations. Only original quantitative studies reporting effect measures of interventions were included, using the condom usage behavior as common comparator: A) Restrictive sexual behavior + Safer sex self-efficacy; B) Restrictive sexual behavior + Safe sex with a condom; C) Restrictive sexual behavior + Safe sex with a condom + Social Support. Mean, SD, SE and 95% CI were estimated, and interventions were ranked using SUCRA radial. Four studies and 9 interventions were included. The most effective strategy was safer receptive sex with transgender people (SUCRA 84.3%), followed by safer sex with non-transgender males (SUCRA 66.11%). Direct and indirect comparisons indicated that interventions promoting safer receptive sex practices among transgender individuals were more effective than those targeting condom use behavior alone. The inclusion of gender-specific content and social support appears to enhance the impact of prevention strategies.

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