Preferences for longer acting pre-exposure prophylaxis in transgender and gender expansive texans: centering gender affirming hormone therapy.

The prevalence of HIV is higher in the transgender population than in the general population, and pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention strategy for the prevention of HIV. However, the transgender and gender-expansive community faces several challenges to PrEP uptake and adherence. This community-based participatory study was conducted to understand preferences for long-acting PrEP modalities better. Data were collected virtually with an adapted version of the World Café Conversation method and in-depth interviews. A total of 33 transgender and gender-diverse individuals participated in either a World Café conversation or an individual interview about preferences for long-acting PrEP. All qualitative data were transcribed and coded for themes. Two themes emerged: (1) challenges related to long-acting PrEP for transgender and gender-expansive individuals and (2) bundling long-acting PrEP and gender-affirming hormone therapy. To improve access and adherence, HIV prevention needs to be included as part of gender-affirming hormone therapy to align with patients' health priorities.