Additional Study Information: We are conducting a study to see if offering pre-exposure prophylaxis (PrEP) together with another health service that many transgender women use or would like to use, gender-affirming hormone therapy (GAHT), improves HIV-related outcomes, as compared to offering PrEP and referring study participants to get GAHT at area health providers. This study is for adults who were assigned male at birth and who currently identify themselves as women, transgender women, women of the trans experience, or along a trans-feminine spectrum; are sexually active, and HIV-negative. Everyone participating will be offered PrEP at the study center. Study participants will also have access to GAHT. If you are eligible for the study and decide to enroll, you will be compensated up to $75 for each of eight scheduled study visits. At each visit you will be asked to provide blood samples; at some visits, you will also be asked to provide samples to test for sexually transmitted infections. Thank you for your ongoing support of HIV prevention research in New York!