Article Text

Original research
Factors associated with attitudes towards HIV cure research among transgender women and travestis: a cross-sectional survey in São Paulo, Brazil
  1. Robert J Wozniak1,
  2. Natalia B Cerqueira2,
  3. Maria Candida S Dantas2,
  4. Bianca Mahafe2,
  5. Daniel A C Barros2,
  6. Edmilson Alves de Medeiros2,
  7. Ana Carolina Soares de Oliveira2,
  8. Thiago Sabino2,
  9. Albert Roggenbuck2,
  10. Vivian Iida Avelino-Silva2,
  11. Carrie D Johnston1,
  12. Jez L Marston1,
  13. Sebastian C Bidegain1,
  14. Manya Magnus3,
  15. Esper G Kallas2,
  16. Douglas F Nixon1,
  17. Camila S Donini2
  1. 1Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York, USA
  2. 2Department of Infectious and Parasitic Diseases, University of Sao Paulo, São Paulo, São Paulo, Brazil
  3. 3Department of Epidemiology, The George Washington University, Washington, District of Columbia, USA
  1. Correspondence to Robert J Wozniak; rjw4001{at}


Objective Characterising the perceptions of groups most affected by HIV is fundamental in establishing guidelines for biomedical advancement. Although Brazil has successfully fought HIV/AIDS through several measures, transgender women still have a likelihood of HIV infection 55 times higher than the general population. This study aimed to better understand the perception and awareness of HIV cure research among the trans-identifying population in São Paulo, Brazil, and to determine factors that motivate or discourage participation in HIV cure studies.

Setting This cross-sectional study analysed data collected from a questionnaire administered to 118 transgender women and travestis at 5 sites within the city of São Paulo. It uses quantitative methodology to describe the perspectives of transgender and travesti people in relation to HIV cure research and the context in which such perspectives are produced.

Results Of 118 participants, most participants (73%) had some knowledge of HIV cure research and were most willing to participate in online surveys (52%), interviews (52%), focus groups (52%) and studies involving blood draws (57%). Those with a higher education or employment status were more likely to agree that someone had been cured of HIV, people living with HIV are discriminated against, and more information about HIV cure research is needed before the community embraces it. Only 55% of participants completely trusted their physician. The biggest motivational factors included gaining additional knowledge about HIV infection (77%) and the potential for a longer, healthier life for all (73%).

Conclusions As a primary analysis of HIV cure attitudes among the transgender and travesti population as well as the social context in which they are formed, this study identifies opportunities to strengthen the dialogue and develop more educational collaborations between scientific investigators, community educators and the trans-identifying population to ensure that HIV cure research is inclusive of diverse perspectives.

  • epidemiology
  • health & safety
  • international health services
  • quality in health care
  • HIV & AIDS
  • public health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors All authors contributed to the study conception and design. Material preparation was performed by RJW, NBC, MCSD, BM, DACB, ACSdO, VIA-S, CDJ, JLM, SCB, MM, EGK, DFN and CSD. Data collection was performed by RJW, NBC, BM, EAM, ACSdO, TS and AR. Data analysis was performed by RJW, NBC, ACSdO, DFN and CSD. The first draft of the manuscript was written by RJW, NBC, ACSdO, DFN and CSD. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. DFN and CSD are shared last authors.

  • Funding This work was supported by the National Institute of Allergy and Infectious Diseases, grant number UM1AI126617 (to the Martin Delaney BELIEVE Collaboratory), with cofounding support from the National Institute on Drug Abuse, the National Institute of Mental Health, and the National Institute of Neurological Disorders and Stroke. RJW was funded in part by the WCM Office for Global Health Education. CDJ is funded by the NIH NIAID, grant number T32AI007613. The research was also made possible by the District of Columbia Center for AIDS Research, an NIH funded program, grant number AI117970, which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was submitted and approved by the HCFMUSP institutional review board (#CAAE 15543219.2.0000.0068 ‘Plataforma Brasil’). All study participants signed an informed consent form that was securely stored separately from the questionnaire. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. Extra data can be accessed via the Dryad data repository at with the doi:10.5061/dryad.pc866t1mk.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.