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Publication Profiles

HIV pre-exposure prophylaxis programme preferences among sexually active HIV-negative transgender and gender diverse adults in the United States: a conjoint analysis

Citation

Watson DL, Listerud L, Drab RA, Lin WY, Momplaisir FM, Bauermeister JA. HIV pre-exposure prophylaxis programme preferences among sexually active HIV-negative transgender and gender diverse adults in the United States: a conjoint analysis. J Int AIDS Soc. 2024;27(2):e26211. doi:10.1002/jia2.26211

Implementation stage:

Pre-Implementation

Implementation outcomes reported:

Acceptability

Continuum target addressed:

Linkage to preventative care, PrEP initiation, PrEP persistence

Geography:

Non-priority jurisdiction

Study Participant Classification:

Recipients of care

Plain Language Objectives

The researchers wanted to learn which features transgender and gender-diverse adults prefer in HIV-prevention programs. They compared cost, location, visit frequency, travel time, and whether services could be combined with gender-affirming hormone care.

Plain Language Abstract

Transgender and gender-diverse people do not have equitable access to pre-exposure prophylaxis, or PrEP, and programs may not reflect their priorities. In 2022, researchers surveyed 304 sexually active HIV-negative transgender adults across the United States. Participants repeatedly chose among hypothetical PrEP programs that differed in cost, dispensing site, visit frequency, travel time, and ability to combine PrEP with gender-affirming hormone services. The median age was 24; 54% identified as transmasculine, 32% as nonbinary, and 14% as transfeminine. Out-of-pocket cost was the most influential feature, accounting for 44.3% of measured preference, followed by integration with hormone care at 18.7%. Zero cost was strongly preferred. Participants with prior PrEP experience favored primary-care delivery, while those without experience favored pharmacies. The findings suggest that low-cost services integrated with gender-affirming care may better match participant preferences. However, choices among hypothetical programs do not necessarily predict actual use. The sample was predominantly transmasculine and nonbinary, so preferences may differ in other transgender populations.

Key Takeaways

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