Description

HIV prevalence among transgender women—particularly those of racial/ethnic minorities—is the highest in the U.S. The odds of a trans woman having HIV is estimated to be over 30 times that of other U.S. adult populations, and rising. Researchers from SDSU, RAND Corporation, and the LA LGBT Center are collaborating to bring comprehensive PrEP services to scale at the Transgender Wellness Center (TWC), a program of community-based, transgender-allied healthcare providers that serves a racially, ethnically, and economically diverse transgender community in LA. The PrEP Well project aims to identify the broad health needs of TWC clients by pinpointing service gaps in the provision of HIV prevention services and collects data on clients’ and providers’ preferences for the implementation of PrEP services at the TWC. In year 1 of the PrEP Well project, qualitative data was collected through individual interviews with TWC clients (n=30; 11 Spanish-speaking, 19 English-speaking) as well as with TWC providers and stakeholders (n=10). All interviews were recorded, professionally transcribed, and analyzed using rapid qualitative analysis to identify salient themes.Similar themes emerged throughout the participant interviews including awareness of PrEP, but a low rate of PrEP uptake and a need for assistance with transportation to and from PrEP-related appointments. Participants cited a lack of access to PrEP due to perceptions about costs, social stigma, and/or fear of potential side effects. Other themes included a distrust of healthcare providers and a lack of trans providers and providers of color. Themes from provider and stakeholder interviews related to strategies to bring PrEP Well to scale within the existing TWC infrastructure, including the need for increased staff and providers, novel community-centered outreach strategies, and leadership buy-in. All providers/stakeholders emphasized the importance of offering incentives to clients who participate in the program.This study identified information to bring comprehensive PrEP services to scale at the TWC. Through qualitative analysis, the needs, ideas, and preferences of TWC clients, providers, and stakeholders will inform the implementation of a comprehensive “one-stop-shop” PrEP clinic.