Transgender women are the population most affected by the HIV/AIDS epidemic in Peru because of issues that occur at individual, interpersonal, socio-cultural, and structural levels, as our team has demonstrated in previous research. A combination, multilevel intervention approach is needed incorporating strategies in order to address internalized oppression, self-regulation abilities, and sexual self-knowledge, along with biomedical approaches to HIV prevention. This proposal aims to conduct a one year qualitative study leading to an NIH grant to develop such an intervention strategy. We will assess the acceptability of biomedical approaches to HIV prevention among transgender women (transwomen) in Peru. These will include PrEP, microbicides, HIV testing every 3 months, and high levels of adherence to antiretroviral medications (ARVs). Additionally we will determine and outline the components of a multi-level HIV prevention intervention, including a comprehensive health program for transwomen. A variety of methods will be used including: a) conducting interviews with health care providers; b) conducting focus groups with transwomen on their health needs and reactions to ideas about a health program targeting these needs; and c) developing a small group HIV prevention intervention that addresses internalized oppression, selfregulation abilities, sexual self-knowledge, and motivation and support for using various biomedical approaches and the health program, and to obtain HIV testing every 3-months. Data will be analyzed by using template analysis, a standard qualitative technique for identifying and organizing themes through the development of a coding template. This study will involve a community advisory board comprised of individuals in health care, transwomen, and transactivists that will provide: advice at the start of the project, input on research findings, and advice about moving forward with the intervention ideas. The information generated will be used to develop the outline of a combination prevention intervention for transwomen.