Intention to use long-acting pre-exposure prophylaxis among transgender women in Argentina: a multi-method analysis

In Argentina, oral pre-exposure prophylaxis (PrEP) uptake and persistence remain low among transgender women (TGW), despite being free of charge. Long-acting PrEP (LA-PrEP) can potentially improve engagement in this population. This study analyzed knowledge of PrEP modalities, intention to use LA-PrEP, and correlates of such intention among TGW in Argentina. A multi-method study was conducted between January and July 2023. A focus group discussion was conducted (n = 12 TGW) and analyzed using thematic content analysis. Then, a structured questionnaire, assessing knowledge of and intention to use LA-PrEP, was administered to 89 TGW. Correlates of intention were examined using bivariate and multivariate analyses. Qualitative findings showed limited PrEP knowledge. For LA-PrEP, participants noted advantages (e.g., greater privacy and fewer side effects) and concerns (e.g., potential interactions with hormone therapy and incompatibility of gluteal injections with liquid silicone). Quantitative results showed that most participants reported high intention to use LA-PrEP (65.2%). Current engagement in sex work and oral PrEP use were positively associated with intention. Interest in using LA-PrEP is high among TGW in Argentina, particularly among those with greater psychosocial vulnerabilities. Integrating LA-PrEP into gender-affirming care and addressing concerns related to liquid silicone injections and hormone interactions, will support implementation.