PrEP and PEP: awareness, use, and preferences among Latina immigrant transgender women in the Washington DC metropolitan area

Latina immigrant transgender women are disproportionately affected by the HIV epidemic in the United States yet are rarely the focus of HIV-prevention research. This longitudinal concurrent mixed-methods study examined pre- and post-exposure prophylaxis (PrEP and PEP) awareness, use, and preferences among 37 HIV-negative Latina immigrant transgender women living in the Washington, DC metropolitan area. Overall, awareness, use, and preference were higher for PrEP than PEP. Many participants, however, expressed interest in PEP once learning about it and nearly all expressed the intention to use PEP in the case of risk exposure. When asked to explain their preferences, three key themes emerged from the qualitative data: PrEP and PEP in the body, familiarity and access, and self-perceived risk. Despite the higher awareness, preference, and use of PrEP, there is interest in PEP among Latina immigrant transgender women. For individuals who are unsuitable candidates for PrEP - due to infrequent HIV exposure or unpredictable sexual risk - PEP remains a reliable and effective method of HIV prevention. Both PrEP and PEP are important strategies that should be promoted as part of the menu of HIV prevention options for this population.