The Transgender Women of Color Initiative: Implementing and Evaluating Innovative Interventions to Enhance Engagement and Retention in HIV Care

Rebchook, Greg; Keatley, JoAnne; Contreras, Robert; Perloff, Judy; Molano, Luis Freddy; Reback, Cathy J.; Ducheny, Kelly; Nemoto, Tooru; Lin, Royce; Birnbaum, Jeffrey M.; Woods, T.; Xavier, Jessica

doi:10.2105/ajph.2016.303582

Cited by 63 publications

(41 citation statements)

References 19 publications

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“…Studies across the U.S. are underway to determine effective strategies for specifically engaging transgender women of color in HIV care and treatment adherence. From 2012 to 2017, the Health Services and Resources Administration’s (HRSA) Special Programs of National Significance (SPNS) funded nine demonstration projects under the Enhancing Engagement and Retention in Quality HIV Care for Transgender Women of Color Initiative [59, 60]. Now nearing completion, most of the HRSA SPNS funded projects combine peer-led community outreach with a variety of other approaches (e.g., case management, small group sessions, motivational interviewing, etc.)…”

Section: Hiv Prevention Interventionsmentioning

confidence: 99%

HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action

et al. 2017

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Purpose of review The purpose of this review is to summarize the available evidence-based HIV prevention interventions tailored for transgender people. Recent findings A limited number of evidence-based HIV prevention interventions have been tested with transgender populations. Most existing interventions target behavior change among transgender women, with only one HIV prevention program evaluated for transgender men. Studies addressing biomedical interventions for transgender women are ongoing. Few interventions address social and structural barriers to HIV prevention, such as stigma, discrimination, and poverty. Summary Evidence-based, multi-level interventions that address the structural, biomedical, and behavioral risks for HIV among transgender populations, including transgender men, are needed to address disparities in HIV prevalence. Future research should address not only PrEP uptake and condom use, but also structural barriers that limit access to these prevention strategies.

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Section: Hiv Prevention Interventionsmentioning

confidence: 99%

HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action

et al. 2017

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“…Transwomen reported limited finances, transportation concerns and fear of discrimination resulting in choosing cross-sex hormone therapy (which induces desired feminizing features among transwomen) over HIV care [23][24][25][26]. However, community clinics in San Francisco offer both trans healthcare and HIV care, which may reduce the need to prioritize one type of care over another [21,27]. Our contrary findings may support the notion that models of HIV care for transwomen will benefit from integration of trans-specific care.…”

Section: Discussionmentioning

confidence: 99%

Successes and final challenges along the HIV care continuum with transwomen in San Francisco

et al. 2019

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Introduction To examine the HIV care continuum for transwomen living in San Francisco and to determine factors associated with poor HIV ‐related health outcomes. Methods Data were collected from 2016 to 2017 with transwomen in San Francisco. Respondent‐driven sampling ( RDS ) was used to recruit a population‐based sample. Bivariate associations were assessed, and RDS ‐weighted multivariable logistic regression was used to identify associations between exposures and outcomes along the HIV care continuum. Results Of the 123 self‐identified transwomen in this analysis, ages ranged from 23 to 71 years with a majority identifying as Latina (40.8%) and African American (29.2%). An estimate of 14.3% of participants were not engaged in care, 13% were not currently on antiretroviral therapy ( ART ), 22.2% had a self‐reported detectable viral load and 13.5% had unknown viral load. Those using hormones had lower odds of not being on ART compared to those who did not use hormones. Those with unstable housing had a higher relative risk ratio of having a detectable viral load. Those who experienced both anti‐trans discrimination and racism had higher odds of not being in HIV care. Conclusions San Francisco has made substantial progress engaging transwomen in the HIV care continuum, but the final push to ensure viral suppression will require addressing social determinants. Future interventions to increase HIV care engagement, ART use and viral suppression among transwomen must address housing needs and risks related to the overlapping effect of both anti‐trans discrimination and racism.

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“…An incomplete understanding of how risk profiles and health outcomes among transgender women have or have not changed over longer periods of time limits the ability of public health professionals to implement targeted interventions focused on high-risk transgender populations. For instance, while there have been extensive efforts in the past decade to increase health research and implement tailored interventions for transgender women (22–27), the impact of these efforts remains unclear without data from comparison studies across time.…”

Section: Introductionmentioning

confidence: 99%

Health Disparities, Risk Behaviors and Healthcare Utilization Among Transgender Women in Los Angeles County: A Comparison from 1998–1999 to 2015–2016

et al. 2018

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Data from two studies of transgender women in Los Angeles County that used the same methodology and survey assessment (Study 1: 1998–1999, N=244; Study 2: 2015–2016, N=271), compared structural determinants of health, HIV/STI prevalence, HIV risk behaviors, substance use, gender confirmation procedures, and perceived discrimination and harassment/abuse across a 17-year time period. Findings demonstrated that participants in the latter study reported significantly higher access to healthcare insurance and prescription hormones. However, participants in the latter study also reported lower levels of income; and, elevated prevalence of homelessness, HIV and lifetime STIs, receptive condomless anal intercourse with casual partner(s), and reported physical harassment/abuse. Given the timeframe of these results, these findings elucidate specific areas of transgender women’s health and risk profiles that improved or worsened across 17 years. While healthcare access has improved, transgender women continue to face significant barriers to good health, indicating the need for increased attention to this population.

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The Transgender Women of Color Initiative: Implementing and Evaluating Innovative Interventions to Enhance Engagement and Retention in HIV Care

Cited by 63 publications

References 19 publications

HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action

HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action

Successes and final challenges along the HIV care continuum with transwomen in San Francisco

Health Disparities, Risk Behaviors and Healthcare Utilization Among Transgender Women in Los Angeles County: A Comparison from 1998–1999 to 2015–2016

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