Transgender Women’s Concerns and Preferences on Potential Future Long-Acting Biomedical HIV Prevention Strategies: The Case of Injections and Implanted Medication Delivery Devices (IMDDs)

Abstract

There are several long-acting biomedical HIV prevention products in the development pipeline, including injections and implanted medication delivery devices (IMDDs). It is critical to understand concerns and preferences on the use of these products in populations that shoulder a disproportionate burden of the HIV epidemic, such as transgender women. This will allow researchers and public health professionals to construct interventions tailored to the needs of these women to promote optimal use of these tools. In studies of other biomedical HIV prevention products (e.g., oral PrEP) it is clear that transgender women have unique concerns related to the use of these strategies. This may have an impact on this group's uptake and sustained use of longacting HIV prevention products. This study conducted four focus groups with N=18 transgender

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

“…These Standards of Care pertain to prepubescent gender diverse children and are based on research, ethical principles, and accumulated expert knowledge. The principles underlying these standards include the following 1) childhood gender diversity is an expected aspect of general human development (Endocrine Society and Pediatric Endocrine Society, 2020 ; Telfer et al., 2018 ); 2) childhood gender diversity is not a pathology or mental health disorder (Endocrine Society and Pediatric Endocrine Society, 2020 ; Oliphant et al., 2018 ; Telfer et al., 2018 ); 3) diverse gender expressions in children cannot always be assumed to reflect a transgender identity or gender incongruence (Ehrensaft, 2016 ; Ehrensaft, 2018 ; Rael et al., 2019 ); 4) guidance from mental health professionals (MHPs) with expertise in gender care for children can be helpful in supporting positive adaptation as well as discernment of gender-related needs over time (APA, 2015 ; Ehrensaft, 2018 ; Telfer et al., 2018 ); 5) conversion therapies for gender diversity in children (i.e., any “therapeutic” attempts to compel a gender diverse child through words, actions, or both to identify with, or behave in accordance with, the gender associated with the sex assigned at birth are harmful and we repudiate their use (APA, 2021 ; Ashley, 2019b , Paré, 2020 ; SAMHSA, 2015 ; Telfer et al, 2018 ; UN Human Rights Council, 2020 ).…”

Zero knowledge and high interest in the use of long-acting injectable pre-exposure prophylaxis (PrEP) among adolescent men who have sex with men and transgender women in two capital cities in Brazil

“…In addition, the lack of information on the characteristics and effects of this drug reduced the confidence in LAI-PrEP’s protection and efficacy [ 24 , 29 ] and increased the individual’s fear on the effects of using a higher medication dosage compared with oral PrEP [ 22 , 24 , 26 , 27 , 30 ]. Among the participating TGW, this concern or skepticism about the effects of LAI-PrEP stems from the possible interference with feminizing hormone therapy ( [ 27 , 28 ].…”

“…Our findings show some specificities and congruence in relation to the findings of qualitative and quantitative studies that analyzed the use of alternative methods for the daily usage of PrEP pill. In this sense, the profile and identification of participants as vulnerable adolescents is the highlight of the study; looking at the panorama of quali-quantitative research, only a few studies contemplate this target audience [22][23][24][25][26], consider transgender [27,28], consider previous PrEP usage experience [29], determine the level of PrEP adherence [26], or take into account the first experiences of using LAI-PrEP [23,30].…”

Understanding the Acceptability of Subdermal Implants as a Possible New HIV Prevention Method: Multi-Stage Mixed Methods Study

“…Although these outcomes may not present a barrier to use for these men, this is not the case for all potential users. For example, other studies have shown that some transgender women were concerned that mild scarring and other skin-related reactions related to potential future PrEP implants could become serious [ 40 , 41 ]. Thus, it may be necessary to engage novel strategies to communicate actual risk [ 41 ], as some populations may overestimate this.…”

“…For example, other studies have shown that some transgender women were concerned that mild scarring and other skin-related reactions related to potential future PrEP implants could become serious [ 40 , 41 ]. Thus, it may be necessary to engage novel strategies to communicate actual risk [ 41 ], as some populations may overestimate this. Icon arrays, which communicate risk using graphical representations of icons symbolizing people affected by a given outcome (eg, circles), may be one such strategy [ 42 ].…”