{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:26:24Z","timestamp":1791483984957,"version":"4.3.4"},"reference-count":54,"publisher":"CSIRO Publishing","issue":"1","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":570,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R21HD107988"],"award-info":[{"award-number":["R21HD107988"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transgender women (TGW) are disproportionately affected by HIV, and HIV prevalence among TGW in Thailand has been increasing. Although oral daily pre-exposure prophylaxis (PrEP) is effective for HIV prevention, PrEP uptake and persistence among TGW have been low. This study aimed to provide a deeper understanding of TGW\u2019s experiences with PrEP uptake and adherence, and to identify major barriers to PrEP use to inform intervention adaptation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We interviewed 20 young TGW (six non-PrEP users, eight adherent, six non-adherent) and 10 health care providers from two HIV clinics in Bangkok, Thailand, in 2022. We focused on understanding challenges to PrEP use in this population using an interview guide based on a theoretical model of behaviour change and thematic content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thematic analysis identified major barriers to and facilitators of PrEP uptake and adherence. Barriers to PrEP initiation included low self-perceived HIV risk, concern about potential side-effects, patient burdens such as frequent HIV testing for prescription refills and social stigma against PrEP. Barriers to adherence included side-effects, inconvenient access to health services (especially during COVID-19 lockdowns), forgetfulness resulting from busy schedules and low self-perceived HIV risk. TGW also reported health care providers\u2019 stigma against PrEP users deterred them from seeking further PrEP services. TGW identified major facilitators of PrEP initiation, including awareness about the benefits of PrEP, concern about risks of HIV and supportive social networks of PrEP users. As to PrEP regimens, most TGW participants reported a clear preference for long-lasting, injectable PrEP over daily oral PrEP. TGW and health care providers largely agreed on barriers and facilitators of PrEP use, but they differed in perceptions of HIV risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results highlighted challenges and opportunities to improve the delivery of PrEP, as well as other sexually transmissable infection and mental health services, especially among TGW. Thus, there is an urgent need for developing effective intervention programs that could raise PrEP awareness and knowledge, reduce PrEP stigma, and improve PrEP delivery systems among TGW in Thailand.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh23102","type":"journal-article","created":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T18:42:55Z","timestamp":1705257775000},"source":"Crossref","is-referenced-by-count":6,"title":["Lived experiences with pre-exposure prophylaxis uptake and adherence among transgender women in Thailand: a qualitative study"],"prefix":"10.1071","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8054-482X","authenticated-orcid":true,"given":"Rena","family":"Janamnuaysook","sequence":"first","affiliation":[{"name":"AInstitute of HIV Research and Innovation, Bangkok, Thailand."},{"name":"BCenter of Excellence in Transgender Health (CETH), Chulalongkorn University, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Guo","sequence":"additional","affiliation":[{"name":"CGraduate School of Public Health and Health Policy, City University of New York, New York, NY, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon Jung","family":"Yu","sequence":"additional","affiliation":[{"name":"DDepartment of Anthropology, Western Washington University, Bellingham, WA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0036-3165","authenticated-orcid":true,"given":"Nittaya","family":"Phanuphak","sequence":"additional","affiliation":[{"name":"AInstitute of HIV Research and Innovation, Bangkok, Thailand."},{"name":"BCenter of Excellence in Transgender Health (CETH), Chulalongkorn University, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surinda","family":"Kawichai","sequence":"additional","affiliation":[{"name":"ECenter of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"MacDonell","sequence":"additional","affiliation":[{"name":"FCenter for Translational Behavioral Research, Florida State University, Tallahassee, FL, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thidarat","family":"Jupimai","sequence":"additional","affiliation":[{"name":"ECenter of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chokechai","family":"Rongkavilit","sequence":"additional","affiliation":[{"name":"GDepartment of Pediatrics, University of California San Francisco-Fresno Branch Campus, Fresno, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5132-7685","authenticated-orcid":true,"given":"Bo","family":"Wang","sequence":"additional","affiliation":[{"name":"HDepartment of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2024,1,15]]},"reference":[{"issue":"1","key":"2025102615325792500_R1","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1071\/SH20134","article-title":"The continuing HIV epidemic among men who have sex with men and transgender women in the ASEAN region: implications for HIV policy and service programming.","volume":"18","author":"van Griensven","year":"2021","journal-title":"Sex Health"},{"issue":"3","key":"2025102615325792500_R2","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/S1473-3099(12)70315-8","article-title":"Worldwide burden of HIV in transgender women: a systematic review and meta-analysis.","volume":"13","author":"Baral","year":"2013","journal-title":"Lancet Infect Dis"},{"issue":"12","key":"2025102615325792500_R3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0260063","article-title":"The worldwide burden of HIV in transgender individuals: an updated systematic review and meta-analysis.","volume":"16","author":"Stutterheim","year":"2021","journal-title":"PLoS ONE"},{"key":"2025102615325792500_R4","unstructured":"UNAIDS. 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