Participants will be assigned to one of two study groups:
1. Participants will receive PrEP, STI screening and treatment, co-located gender affirming services and Peer Health Navigation using Strengths-Based Case Management at the study site for 18 months.
OR
2. For the first 6 months, participants will receive PrEP, STI screening and treatment, but will be referred to receive gender affirming and health navigation services outside the study site. From 6-18 months, participants in this arm will receive PrEP, STI screening and treatment, co-located gender affirming services and Peer Health Navigation using Strengths-Based Case Management at the study site.