Table 3 Characteristics of optimal HIV prevention package for TP
Component | Content description | Provision description |
|---|---|---|
All components | Provision of services based on the needs of TP. | • Needs/risk assessment before service provision. |
Counselling | • Counselling on transition. • Psychological counseling. • HIV prevention counseling for TP at high risk of HIV infection. • Consultation by physician at NGO office. | • Counseling using social networks and mobile applications, online counseling, hotline and counseling directly in the NGO office. • Feedback provision during the remote counseling, linkage to services. • Peer-to-peer counseling, online and face-to-face. • Provision of counselling by TP with positive experience of transition. |
Referral and navigation | • Appointment with a doctor (if needed). • Referral and navigation (if needed) to medical services (prescription and monitoring of hormone replacement therapy, medical examination, enrolment in HIV care, etc.) and legal services (paperwork, etc.). | • Creation of the pool of friendly doctors who are ready to help TP, and therefore willing to receive the appropriate training. • Training of doctors on service provision for TP. • Training of multidisciplinary teams for provision of package medical services for TP. |
Distribution of prevention tools and educational materials | • Distribution of information and educational materials on transition. • Provision of prevention tools that meet the needs of TP: lubricants in tubes, femidomas, latex wipes. | • Development of information materials related to transition, as well as materials on HIV and STIs prevention following the characteristics of sexual behaviours of TP. • Dissemination of printed information materials in NGO office and e-materials through the social networks. |
HIV/STI testing | • HIV/ STI self-testing. • Partners’ testing (if needed and possible). | • Use of test kits that examine oral fluid. |
PrEP | • PrEP in NGO office. | • Access to PrEP for TP at risk (sex workers, HIV-negative partners in discordant couples etc.) or with latex allergy. • Consultation on possible drug interactions (PrEP and hormone replacement therapy). |
PEP | • Health care facility based PEP. | • Provision of information on the availability of PEP, referral and navigation to PEP for those at risk. • Consultation on possible drug interactions between (PEP and hormone replacement therapy). |
Financial support | • Financial compensation for services related to transition. | Options for financial compensation: • Hormone testing. • Hormone replacement therapy. • Medical consultations. • Transition-related surgeries. • Document changing fees. • Hostel payment. • ‘Tightenings’ or other items for everyday living. |
TB screening | • TB screening questionnaire. | If needed. |