High interest in Long-Acting Injectable PrEP among Filipina Transfeminine Adults

Transfeminine adults are impacted by the HIV epidemic in the Philippines, and newly approved modalities of pre-exposure prophylaxis (PrEP), including long-acting injectable (LAI-PrEP), could be beneficial for this group. We utilized secondary data from the #ParaSaAtin survey that sampled Filipina transfeminine adults (n=139) and conducted a series of multivariable logistic regressions with lasso selection to explore factors independently associated with PrEP outcomes, including awareness, discussion with trans friends, and interest in LAI-PrEP. Overall, 53% of Filipina transfeminine respondents were aware of PrEP, 39% had discussed PrEP with their trans friends, and 73% were interested in LAI-PrEP. PrEP awareness was associated with being non-Catholic, having previously been HIV tested, discussing HIV services with a provider, and having high HIV knowledge (p<0.05). Discussing PrEP with friends was associated with older age, having experienced healthcare discrimination due to transgender identity, having HIV tested, and having discussed HIV services with a provider (p<0.05). Interest in LAI-PrEP was associated with living in Central Visayas, having discussed HIV services with a provider, and having discussed HIV services with a sexual partner were associated (p<0.05). Implementing LAI-PrEP in the Philippines requires addressing systemic improvements across personal, interpersonal, social, and structural levels in healthcare access, including efforts to create healthcare settings and environments with providers who are trained and competent in transgender health and can address the social and structural drivers of trans health inequities, including HIV and barriers to LAI-PrEP. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The authors declare that they have no conflict of interest, including financial. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study acquired approval from Institutional Review Board of the Brown University Brown University Human Research Protection Program (IRB Protocol, #1802001982). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Given that this study contains data with potentially sensitive information, data from this study are available upon request. Contact the Brown University Human Research Protection Program Institutional Review Committee (irb{at}brown.edu) for data requests.