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Transgender Women’s Concerns and Preferences on Potential Future Long-Acting Biomedical HIV Prevention Strategies: The Case of Injections and Implanted Medication Delivery Devices (IMDDs)

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Abstract

There are several long-acting biomedical HIV prevention products in the development pipeline, including injections and implanted medication delivery devices (IMDDs). It is critical to understand concerns and preferences on the use of these products in populations that shoulder a disproportionate burden of the HIV epidemic, such as transgender women. This will allow researchers and public health professionals to construct interventions tailored to the needs of these women to promote optimal use of these tools. In studies of other biomedical HIV prevention products (e.g., oral PrEP) it is clear that transgender women have unique concerns related to the use of these strategies. This may have an impact on this group’s uptake and sustained use of longacting HIV prevention products. This study conducted four focus groups with N = 18 transgender women in New York City to understand their concerns and preferences on long-acting PrEP injections and IMDDs. Findings showed that participants were overwhelmingly positive about long-acting HIV prevention strategies, though they had some apprehensions. Overall, participants felt that injections and IMDDs could help address adherence challenges, and that transgender-specific needs should be addressed during clinical trials. Also, there were concerns related to injection or IMDD logistics, concerns about injections’ or IMDDs’ presence in the body, and familiarity with these products affected participants’ opinions on them. Findings from this work can be used to inform protocols, measures, materials, and adherence interventions in future initiatives for transgender women using PrEP injections or IMDDs.

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Acknowledgements

Data collection support was provided by Project AFFIRM (R01 HD079603; Principal Investigator, Walter Bockting, Ph.D.) and a generous grant from the Mac AIDS Fund (MAF CU13-3233; Principal Investigator: Walter Bockting, Ph.D.). The first author is supported by a K01 Award from the National Institute of Mental Health (K01 MH115785; Principal Investigator: Christine Tagliaferri Rael, Ph.D.) from the National Institute of Mental Health at the HIV Center for Clinical and Behavioral Studies at the NY State Psychiatric Institute and Columbia University (P30 MH43520; Center Principal Investigator: Robert Remien, Ph.D.). Additionally, research was supported by SLAP-HIV (UM1 AI120184; Principal Investigator, Tomas Hope, Ph.D.) and the Third Coast Center for AIDS Research (P30 AI117943; Principal Investigator, Richard D’Aquila, M.D.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. The research team would like to thank all participants for their time, hard work, and critical insight.

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Authors and Affiliations

  1. HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Dr., New York, NY, 10032, USA

    Christine Tagliaferri Rael, Rebecca Giguere & Alex Carballo-Diéguez

  2. Program for the Study of LGBT Health at the New York State Psychiatric Institute/Columbia Psychiatry and the Columbia University School of Nursing, New York, NY, USA

    Michelle Martinez, Walter Bockting, Caitlin MacCrate, Will Mellman & Pablo Valente

  3. CUNY School of Public Health, New York, NY, USA

    Caitlin MacCrate

  4. Columbia University Mailman School of Public Health, New York, NY, USA

    Michelle Martinez & Pablo Valente

  5. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    George J. Greene

  6. Department of Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Susan G. Sherman & Katherine H. A. Footer

  7. Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Richard T. D’Aquila

  8. Northwestern University Feinberg School of Medicine, and Biomedical Engineering in the McCormick School of Engineering and Applied Sciences, Chicago, IL, USA

    Thomas J. Hope

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  1. Christine Tagliaferri Rael
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Correspondence to Christine Tagliaferri Rael.

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Rael, C.T., Martinez, M., Giguere, R. et al. Transgender Women’s Concerns and Preferences on Potential Future Long-Acting Biomedical HIV Prevention Strategies: The Case of Injections and Implanted Medication Delivery Devices (IMDDs). AIDS Behav 24, 1452–1462 (2020). https://doi.org/10.1007/s10461-019-02703-5

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