Barriers and Facilitators to Oral PrEP Use Among Transgender Women in New York City

AIDS Behav. 2018 Nov;22(11):3627-3636. doi: 10.1007/s10461-018-2102-9.


Transgender women may face a disparate risk for HIV/AIDS compared to other groups. In 2012, Truvada was approved for daily use as HIV pre-exposure prophylaxis (PrEP). However, there is a dearth of research about barriers and facilitators to PrEP in transgender women. This paper will shed light on transgender women living in New York City's perceived and actual challenges to using PrEP and potential strategies to overcome them. After completing an initial screening process, four 90-min focus groups were completed with n = 18 transgender women. Participants were asked what they like and dislike about PrEP. Participants identified the following barriers: uncomfortable side effects, difficulty taking pills, stigma, exclusion of transgender women in advertising, and lack of research on transgender women and PrEP. Facilitators included: reducing pill size, increasing the types of available HIV prevention products, and conducting scientific studies to evaluate PrEP in transgender women.

Keywords: Barriers; Facilitators; HIV prevention; PrEP; Transgender women; Transwomen.

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / therapeutic use
  • Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Female
  • Focus Groups
  • HIV Infections / prevention & control*
  • Humans
  • Male
  • New York City
  • Pre-Exposure Prophylaxis / methods*
  • Qualitative Research
  • Social Stigma*
  • Transgender Persons / psychology*


  • Anti-HIV Agents
  • Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination