Table 2. PrEP acceptability among transgender women in India: Findings mapped on to the seven constructs of the Theoretical Framework of Acceptability.

Constructs of the Theoretical Framework of Acceptability	Findings supporting the construct
Perceived effectiveness	Additional protection with condoms Protective in HIV sero-discordant relationships Effective in forced sex encounters in which condoms are unlikely to be used
Intervention coherence	Appropriateness of PrEP for TGW in sex work and those with multiple partners Expressed need for trans community leaders’ support
Affective attitude	Anxiety-free sex Perceived advantages (e.g., if condoms broke) Ability to covertly use PrEP
Burden	High cost of PrEP Daily use/adherence Hiding PrEP use from family/partners/peers
Ethical concerns	Side-effects should be minimal and of short duration Labeling certain groups as eligible for PrEP was perceived to exacerbate PrEP-related stigma
Self-efficacy	Ability to adhere to a daily regimen Discussing and revealing PrEP use with primary male partner
Opportunity costs	Side-effects (that may impact on physical beauty) Fear of interactions with feminizing hormones PrEP-related stigma in TGW communities