Background: We assessed access to pre-exposure prophylaxis (PrEP) and interest in integration of PrEP with gender-affirmative care in a global sample of transmasculine persons.
Methods: Transmasculine persons (N = 590) aged 18 years and above from 57 countries completed a brief online survey from April to July 2022 about sexual behavior, knowledge, and interest in PrEP, current access to PrEP and gender-affirmative care, and preferred context for accessing PrEP. Descriptive analyses were stratified by country income group.
Results: Most participants (54.4%) lived near a health center offering care to trans people. Overall, 1.9% of respondents reported ever receiving a positive HIV test result. Among those who had not (n = 579), more than a third reported engaging in receptive sex in the past year (35.2%) or anticipated doing so in the next year (41.5%), 86.9% had never received information about HIV prevention specific to transmasculine people, and 76.3% had heard of PrEP. Among those who had heard of PrEP (n = 440), only 18.9% had discussed or been offered it by a provider, and only 3.6% were currently taking it-yet 67.9% who had heard of it but were not using it would "definitely" (28.5%) or "maybe" (39.4%) be interested in taking it were it available for free. Out of these participants, the majority (60.5%) preferred the idea of accessing PrEP from the same clinic where they received gender-affirming care.
Conclusions: Interventions are needed to improve PrEP access for transmasculine people globally. Clinics already providing gender-affirming care to trans people are acceptable clinical contexts to integrate such interventions.
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