title: Young Transgender Women's Attitudes Toward HIV Pre-exposure Prophylaxis.
abstract: OBJECTIVE
  Our primary aim was to explore themes regarding attitudes toward HIV pre-exposure prophylaxis (PrEP) among young transgender women (YTW), in order to develop a theoretical model of PrEP uptake in this population disproportionally affected by HIV.
  
  
  METHODS
  Qualitative study nested within a mixed-method study characterizing barriers and facilitators to health services for YTW. Participants completed an in-depth interview exploring awareness of and attitudes toward PrEP. Key themes were identified using a grounded theory approach.
  
  
  RESULTS
  Participants (n = 25) had a mean age of 21.2 years (standard deviation 2.2, range 17-24) and were predominately multiracial (36%) and of HIV-negative or unknown status (68%). Most participants (64%) reported prior knowledge of PrEP, and 28% reported current use or intent to use PrEP. Three major content themes that emerged were variability of PrEP awareness, barriers and facilitators to PrEP uptake, and emotional benefits of PrEP. Among participants without prior PrEP knowledge, participants reported frustration that PrEP information has not been widely disseminated to YTW, particularly by health care providers. Attitudes toward PrEP were overwhelmingly positive; however, concerns were raised regarding barriers including cost, stigma, and adherence challenges. Both HIV-positive and negative participants discussed emotional and relationship benefits of PrEP, which were felt to extend beyond HIV prevention alone.
  
  
  CONCLUSIONS
  A high proportion of YTW in this study had prior knowledge of PrEP, and attitudes toward PrEP were positive among participants. Our findings suggest several domains to be further explored in PrEP implementation research, including methods of facilitating PrEP dissemination and emotional motivation for PrEP uptake.
authors.affiliation: Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: woodsa@email.chop.edu.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Wood
authors.affiliation: Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Susan
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Family Health and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Frances K
authors.initials: FK
authors.lastname: Barg
authors.affiliation: Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Marne
authors.initials: M
authors.lastname: Castillo
authors.affiliation: Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Nadia
authors.initials: N
authors.lastname: Dowshen
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D066296:Grounded Theory; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D065129:Pre-Exposure Prophylaxis; D036301:Qualitative Research; D020377:Self Efficacy; D063106:Transgender Persons / Q000523:psychology*; D055815:Young Adult
keywords: HIV pre-exposure prophylaxis; HIV prevention; Qualitative research; Transgender women