HIV prevention among adolescents travestis and transgender women in three Brazilian capitals, 2019-2023.

Objective: To describe HIV prevention strategies and gender-based discrimination among adolescent travestis and transgender women.

Methods: This was a cross-sectional study involving 148 adolescent travestis and transgender women aged 15 to 19 years in Salvador, Bahia state, São Paulo, São Paulo state, and Belo Horizonte, Minas Gerais state, conducted between February 2019 and March 2023. Fisher's exact test was performed to assess differences between prevention strategies and gender-based discrimination within healthcare services.

Results: 18.9 % reported engaging in receptive anal sex using condom in the past 6 months; 62.2% had undergone HIV test at least once in their lifetime; and 88.5% had started pre-exposure prophylaxis (PrEP) for HIV. Adolescents aged 15 to 17 years with previous experiences of discrimination in healthcare services had undergone fewer HIV tests in their lifetime or had started PrEP less frequently.

Conclusion: There is an urgent need for the implementation of public policies that eradicate gender-based discrimination and expand access to HIV prevention.