# Applying a Behavioral Economic Approach on PrEP and Hormone Options among Transgender Women

> **NIH NIH R21** · UNIVERSITY OF WASHINGTON · 2024 · $259,807

## Abstract

PROJECT SUMMARY/ABSTRACT
 Daily and intermittent/2-1-1 pre-exposure prophylaxis (PrEP) options are promising to end the HIV epidemic
among transgender (trans) women — including in the Philippines where the HIV case infections recently doubled
(1560 cases in 2022 vs. 714 in 2019) within a short timeline in this population.1,107 Understanding end-user input
and preferences of PrEP via behavioral economic approaches like conjoint study designs are vital to maximizing
its effectiveness such as feasibility, acceptability, and sustainability across its care continuum. However, to our
team’s knowledge, no conjoint design studies have been applied to examine trans women’s end-user
preferences for PrEP, including the co-use of gender-affirming hormones. Moreover, the socio-ecological
barriers/facilitators pertinent to influencing PrEP uptake across the personal, social, economic, and structural
levels are underexamined among trans women. As such, along with this study’s Trans Stakeholder and Scientist
Advisory Board, this proposal aims to inform and test a future behavioral economic-based intervention to support
PrEP engagement among trans women, with the following aims: (1) To qualitatively explore and identify all
preferred and accepted attributes and features of PrEP needed to inform a full-profile PrEP program choice-
based conjoint survey study via in-depth interviews with 30 trans women and 15 key informants (i.e., HIV
specialists, primary care providers, PrEP programmers/policymakers), and (2) To quantitatively test and
determine optimal combinations of attributes predictive of Filipinx trans women’s acceptability and preferences
about PrEP modalities via full-profile choice-based conjoint study design with 300 Filipinx trans women to
enhance implementation outcomes (e.g., acceptability, feasibility) of future intervention, and examine socio-
ecological factors that may influence the chosen optimized PrEP program preferences. Findings will provide pilot
data insights to test the identified optimized PrEP program profile(s) via a future larger scale (R01) behavioral
economic-structural strengthening intervention for Filipinx trans women to increase PrEP uptake and reduce HIV
incidence in the Philippines.

## Key facts

- **NIH application ID:** 11005651
- **Project number:** 1R21AI183907-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** DON OPERARIO
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $259,807
- **Award type:** 1
- **Project period:** 2024-06-10 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11005651

## Citation

> US National Institutes of Health, RePORTER application 11005651, Applying a Behavioral Economic Approach on PrEP and Hormone Options among Transgender Women (1R21AI183907-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11005651. Licensed CC0.

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