LAUSR

BACKGROUND This article describes perceptions and experiences related to the pre-exposure prophylaxis (PrEP) care continuum of Mexican men who have sex with men (MSM) and transwomen (TW). METHODS Between June and July 2020, we applied 24 online semi-structured interviews regarding PrEP use with 10 PrEP users, six ex-users, and eight potential users (at risk, not enrolled). RESULTS Awareness: TW did not always receive the information they needed from trusted people. Acceptability: Potential users were reluctant to use PrEP due to fear of side effects, and only a few participants worried about stigma. Uptake: Potential users missed their enrollment visit and did not know how to reschedule. Adherence: Barriers included routine changes interfering with PrEP-taking habits (arriving home later, traveling, etc.) while feeling protected was reported as a facilitator. Retention: Ex-users quit PrEP services, mostly without reducing their HIV risk, because of difficulties keeping appointments and fearing long-term effects. CONCLUSION Inclusive awareness activities, tackling misbeliefs regarding side effects, and more flexible services may improve PrEP usage and enhance its impact.