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Understanding changing LAI-PrEP preferences during the perinatal period could inform the integration into maternal healthcare. We used data from a randomized trial of pregnant women initiating daily oral HIV PrEP at five public maternal child health facilities in western Kenya, followed through 9 months postpartum (NCT04472884). Participants completed surveys on LAI-PrEP interest from the third trimester through postpartum. Latent Transition Analysis (LTA) examined underlying patterns of LAI-PrEP interest. Predictors of transitions between statuses were assessed using univariate logistic regression. Overall, 598 pregnant women were enrolled (median age: 25 years). We identified three preferences statuses: \u201cNo interest in LAI-PrEP\u201d, \u201cWilling to pay (WTP) for LAI-PrEP\u201d, and \u201cPrefers free LAI-PrEP\u201d. About 10% comprised the \u201cNo interest in LAI-PrEP\u201d at each time point. In pregnancy, 36.8% belonged to the \u201cPrefers free LAI-PrEP\u201d status, with participants increasingly transitioning to \u201cWTP for LAI-PrEP\u201d through the postpartum period. The \u201cWTP for LAI-PrEP\u201d status grew from 53.2% in third trimester to 76.6% at nine months postpartum, however women who were primigravida had 5-fold higher odds of transitioning out of \u201cWTP for LAI-PrEP\u201d to \u201cPrefers free LAI-PrEP\u201d (95% CI: 5.29\u20135.39,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Most women remained interested in LAI-PrEP across pregnancy and postpartum, with willingness to pay for LAI-PrEP growing over time. Expanding cost-free LAI-PrEP within MCH systems, especially for postpartum and primigravida women, could improve PrEP use during this critical period.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>ClinicalTrials.gov registration number<\/jats:italic>\n                    : NCT04472884.\n                  <\/jats:p>","DOI":"10.1007\/s10461-026-05197-0","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T03:28:59Z","timestamp":1782703739000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Acting HIV Pre-exposure Prophylaxis Preferences Through Pregnancy and the Postpartum Period Among Women in Kenya: A Latent Transition Analysis"],"prefix":"10.1007","clinical-trial-number":[{"clinical-trial-number":"nct04472884","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2180-3534","authenticated-orcid":false,"given":"Tessa","family":"Concepcion","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9085-1663","authenticated-orcid":false,"given":"Salphine","family":"Watoyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8369-9851","authenticated-orcid":false,"given":"Brian P","family":"Flaherty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0257-2160","authenticated-orcid":false,"given":"Felix","family":"Abuna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7914-7328","authenticated-orcid":false,"given":"Eunita","family":"Akim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2731-0781","authenticated-orcid":false,"given":"Laur\u00e9n","family":"G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4301-1573","authenticated-orcid":false,"given":"Grace","family":"John-Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1259-4884","authenticated-orcid":false,"given":"Emmaculate M.","family":"Nzove","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4176-5950","authenticated-orcid":false,"given":"Nancy","family":"Ngumbau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9913-9034","authenticated-orcid":false,"given":"Jerusha N.","family":"Mogaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9802-1648","authenticated-orcid":false,"given":"Ben O.","family":"Odhiambo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5851-1220","authenticated-orcid":false,"given":"Anjuli D.","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6571-8927","authenticated-orcid":false,"given":"John","family":"Kinuthia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1255-7191","authenticated-orcid":false,"given":"Jillian","family":"Pintye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"5197_CR1","first-page":"508","volume":"33","author":"SP Buchbinder","year":"2025","unstructured":"Buchbinder SP, Liu AY. 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The clinical trial was registered at ClinicalTrials.gov (NCT04472884). All participants provided electronic informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}