Barriers and facilitators to HIV testing among transgender people in Georgia

Qualitative study results using the COM-B Framework

Dados Bibliográficos

ID19593413
AutoresMarine Gogia (0000-0003-1476-0812, Tbilisi State University, autor correspondente), Tamar Zurashvili (0009-0005-0384-5249, Tbilisi State University), Jack DeHovitz (0000-0001-7307-0614), DeHovitz JA (SUNY Downstate Health Sciences University), Mamuka Djibuti (0000-0002-1614-854X, Research for Action)
EditoresDumile Gumede (0000-0001-8739-6033)
Ano2026
Volume6
Fascículo3
Páginase0005819
Data de publicação2026-03-06
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoPLOS Global Public Health (JOURNAL)
Identificadores do periódicoISSN: 2767-3375 • E-ISSN: 2767-3375
EditoraPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0005819
PMID41790610
OpenAlexW7134132815
IdiomaEN
Citações recebidas1
Referências citadas28

Transgender (TG) people face a disproportionately high burden of HIV globally due to stigma, discrimination, criminalization, and limited access to trans-specific healthcare. In Georgia, HIV prevalence among TG individuals is 24.1%, compared with 0.3% in the general adult population. While predictors of HIV testing have been documented, the factors influencing testing behaviors remain insufficiently understood. This study explored barriers and facilitators to HIV testing among TG in Georgia using the Capability, Opportunity, Motivation–Behavior (COM-B) model. We conducted 15 in-depth interviews (IDIs) with TG and non-binary individuals aged 18–45 years in Tbilisi between February–April 2025. Eligible participants were HIV-negative, not enrolled in pre-exposure prophylaxis (PrEP), and recruited with support from community-based organizations. Data were transcribed, coded, and thematically analyzed, with findings mapped to the COM-B framework. Participants (8 TG women, 5 non-binary, 2 TG men; median age 23) identified multiple barriers to HIV testing: limited HIV-related knowledge, low perceived risk and limited interest in testing, confidentiality fears, stigma and discrimination in healthcare settings, geographical barriers, and the influence of substance use and mental health challenges. Facilitators included awareness of free, anonymous, and confidential services; access to outreach-based and self-testing options through community organizations; HIV risk perception; community encouragement and support; social media and dating apps; recognition of testing as self-care and moral responsibility; and financial or non-financial incentives. This study demonstrates that HIV testing behaviors among TG individuals in Georgia are shaped by intersecting individual, structural, and sociocultural factors. While community-based organizations, peer support, and self-testing reduce barriers and enhance engagement, persistent challenges like stigma, low HIV literacy, geographic inequities, and substance use continue to limit uptake. Expanding decentralized, community-driven, and confidential testing services, coupled with targeted education, peer-led interventions, and integration of stigma and discrimination reduction strategies, is essential to improving HIV testing coverage among TGs in Georgia

Confidentiality · Human immunodeficiency virus (HIV) · Mental health · Public health · Qualitative research · Social stigma · Stigma (botany) · Transgender · Young adult · HIV/AIDS Research and Interventions · LGBTQ Health, Identity, and Policy · Sexuality, Behavior, and Technology