Qualitative client perspectives on PrEP well: a community-led PrEP implementation project with structural supports at...

Although pre-exposure prophylaxis (PrEP) is an effective way to prevent HIV infection, PrEP uptake and adherence remain low in transgender and nonbinary (TGNB) communities. This qualitative study explored perspectives on the community-developed PrEP Well program that implemented PrEP services in a TGNB community center. Clients completed an interview approximately 90 days after program enrollment about factors that influenced their participation and suggestions for program improvement. Interviews were audio-recorded, transcribed, translated to English (if conducted in Spanish), de-identified, and analyzed using inductive thematic analysis. Twenty-five participants completed exit interviews. We identified eight themes. Positive experiences included (1) TGNB-centered program (subthemes: program coordinator, environment), (2) improved health, (3) program structure, and (4) improved financial status. Factors that negatively impacted engagement included (5) concerns about PrEP-related side effects and (6) inconvenient program logistics. Suggestions for improvement included (7) a one-stop shop model to reduce client burden and (8) program expansion. TGNB clients found PrEP Well to be acceptable and particularly appreciated that it was TGNB-centered. Future community-led PrEP programs should incorporate all services in one physical location and expand program components and duration in accordance with client needs.