Interest in long-acting injectable PrEP among transgender women in eastern and southern United States

Abstract

Background: Among communities with elevated HIV burden, increased uptake of PrEP, including long-acting injectable (LAI) PrEP, could lower HIV incidence. Lack of data on LAI PrEP interest among transgender women in the US has limited scientific understanding of the potential impact of LAI PrEP on new infections within transgender communities. Our objective was to determine the percent of transgender women interested in LAI PrEP and identify correlates of interest. Methods: Transgender women enrolled in the LITE Cohort who completed 12-month surveys between March 2019 and September 2021 were asked about interest in using LAI PrEP. Prevalence ratios (PR) estimated with modified Poisson regression models assessed for predictors of interest in LAI PrEP. Results: Among 867 participants, 15% were current users of oral PrEP and 11% were former oral PrEP users. 47% reported interest in LAI PrEP. Interest in LAI PrEP was more common among participants who were Black (PR: 1.28; 95% CI: 1.05-1.55), college-educated (PR: 1.28; 95% CI: 1.04-1.57), food insecure (PR: 1.19; 95% CI: 1.00-1.41), and had PrEP indications (PR: 1.44; 95% CI: 1.21-1.71). LAI PrEP interest was also more common among adherent users of oral PrEP and those who had discontinued oral PrEP, compared to PrEP-naïve participants. Conclusions: Interest in LAI PrEP among transgender women varied by demographic and clinical characteristics. Increased interest in LAI PrEP among Black transgender women, those with PrEP indications, and those who had previously discontinued oral PrEP underscores the need to increase LAI PrEP access for transgender women who are interested.