The 2022 PrEP APPEAL online survey included 1,178 transgender women in 11 Asian countries. Awareness was 80.0%; among those aware, 62.6% had ever used PrEP, and 78.1% of ever-users were current users. Among higher-risk PrEP-naïve respondents, 60.0% were willing to use it, but only 34.0% of those willing would pay. Healthcare discrimination was associated with lower lifetime use; causality cannot be inferred.
Key findings
- Awareness was 942/1,178 (80.0%); lifetime use among those aware was 590/942 (62.6%); current use among ever-users was 461/590 (78.1%).
- Among 265 higher-risk PrEP-naïve respondents, 159 (60.0%) were willing, but only 54/159 (34.0%) would pay.
- Wider country access was associated with lifetime use, aOR 4.34, while healthcare discrimination was associated with lower use, aOR 0.66.
Why this matters globally
Asia's PrEP gap includes affordability, availability, and freedom from discrimination, not awareness alone. Cascades can guide communication, subsidy, decentralization, and gender-affirming care, but cross-country differences are not causal and stated willingness is not uptake.
Thai researcher contribution
Rena Janamnuaysook and Nittaya Phanuphak linked IHRI with Chulalongkorn University's transgender-health centre, while Hua Boonyapisomparn represented the Bangkok-based Asia Pacific Transgender Network, combining clinical, academic, rights, and community perspectives.
Limitations to consider
Non-probability online recruitment, self-report, a single 2022 time point, country heterogeneity, and residual confounding limit inference. Willingness is not the same as initiation or persistence.
Verify the original sources
Journal of the International AIDS SocietyJournal of the International AIDS Society↗DOI: 10.1002/jia2.70209