hiv risk perception among transgender women in community-based clinics in thailand Reshmie Ramautarsing1, Thitiyanan Nakpor2, Rena Janamuaysook1, Supabhorn Pengnonyang1, Jureeporn Jantarapakde1, Deondara Trachunthong1, Thanthip Sungsing1, Piyanee Rodbamrung1, Pravit Mingkwanrungruangkit1, Waraporn Sirisakyot1, Sumitr Tongmuang1, Sirichai Jarupittaya1, Noparat Mahachokchai2, Phooritat Yokchawee2, Saman Samalu3 , Manop Uthaikorn 3, Wutthiphan Champa4, Pongpeera Patpeerapong5, Steve Mills6, Sutinee Chareonying6, Matthew Avery6, Praphan Phanuphak1, Michaell Cassell7, Ravipa Vannakit7, Nittaya Phanuphak1 1Thai Red Cross AIDS Research Centre, Bangkok, Thailand, 2Rainbow Sky Association of Thailand, Bangkok, Thailand, 3The Service Workers In Group Foundation, Bangkok, Thailand, 4Caremat Organisation, Chiang Mai, Thailand, 5Mplus Foundation, Chiang Mai, Thailand, 6FHI 360 and USAID LINKAGES Project, Bangkok, Thailand, 7Office of Public Health, U.S. Agency for International Development Regional Development Mission Asia, Bangkok, Thailand.

No conflicts of interest to declare Conflict of interest No conflicts of interest to declare

Background TGW: Risk of HIV is 49 times higher than the general population In Thailand: around ½ of new HIV infections occur in TGW and MSM HIV prevalence among Thai TGW 10 - 15% Objective: Assess self-perceived HIV risk, actual HIV risk and HIV knowledge among Thai TGW in the Community-based Test and Treat Study at enrollment Community-based Test and Treat Study Prospective observational cohort study Assess feasibility of community-based Test and Treat strategies among TGW and MSM to increase uptake of HIV services 6 sites in 4 provinces Reach – recruit – test – counsel – link to care by CHW Baral, Lancet Infect Dis, 2013. Reisner, Lancet, 2016. Thai MoPH 2016.

methods Thai TGW aged ≥ 18 years Self-administered questionnaires prior to HIV testing to assess HIV risk-perception and risk behaviors HIV knowledge: identify correct statements on HIV transmission (9 statements) HIV prevention (6 statements) HIV testing STI screening (Neisseria gonorrhea, Chlamydia trachomatis, syphilis)

May ‘15-Sep ‘16: 726 TGW Mean (SD) age 26.4 (6.7) 53% aged 18-25 years 33% service workers HIV prevalence 9% Any STI 32%

implications Thai TGW with lower self-perceived risk had high actual risk Knowledge on HIV transmission and prevention were similar Self-perceived HIV risk essential to reduce risk behavior, and increase the uptake of HIV testing Low self-perceived HIV risk associated with lower uptake of and adherence to PrEP HIV prevention services that focus on improving knowledge alone may be insufficient to modify the assessment of self-perceived risk Factors that can improve the assessment of risk should be explored Evangeli, AIDS Behav, 2016. Pringle, AIDS Patient Care STDs, 2013. Pengnonyang, IAS, 2017