HIV Risk Reduction for Transgender Women of Color
Alvan Quamina, AIDS Project of the East Bay; Tooru Nemoto, Public Health Institute, Oakland
Social and Behavioral Sciences
Targeted Theme: Practice Informed Translational and Interventions Research
Community Collaborative Research Award
In collaboration among the consortium organizations: AIDS Project East Bay (APEB), Institute Familiar de la Raza (IFR), and Public Health Institute (PHI), the proposed study aims to develop, implement, and evaluate the evidence-based intervention programs to reduce substance abuse and HIV risk behaviors among African American and Latina male-to-female transgender people (transgender women) in San Francisco and Oakland. Studies have reported extremely high HIV infection rates among transgender women in the Bay area and other cities in the U.S., ranging from 16% to 68%, particularly among those engage in sex work and among African Americans and Latinas. Transgender people, including both transgender women and men are exposed to individual and institutional discrimination due to gender identity and are highly vulnerable to substance abuse, HIV/AIDS, and mental health problems. However, the access to transgender specific substance abuse and mental health treatment programs and medical and social services is very limited. Most of all, their human rights and equality are not always protected by law. Transgender women of color are further exposed to health disparities due to their racial/ethnic background and transgender identity. Transgender women are categorized as the highest risk group for HIV/AIDS in San Francisco and California, and elsewhere in the U.S. However, there are no evidence-based HIV prevention intervention models for transgender women.
Under the direction of Dr. Alvan Quamina (PI), APEB has been providing culturally competent HIV/AIDS care and prevention services mainly for African Americans in Oakland. Under a strong leadership of Dr. Estela Garcia, IFR is providing mental health and substance abuse treatment and HIV/AIDS care and prevention services mainly for Latinos in San Francisco. Dr. Tooru Nemoto (Co-PI), PHI has been conducting substance abuse and HIV prevention studies for transgender people in the Bay area for more than 10 years. Nemoto’s study describing substance use and HIV risk behaviors among transgender women of color is a pioneering work in the field. Based on scientific data and collaboration with AIDS service organizations (ASOs), Dr. Nemoto’s project team developed the Transgender Resources and Neighborhood Space (TRANS) which had provided HIV prevention and health promotion programs for transgender women and men. However, the SAMHSA-funded TRANS service project was not developed based on a rigorous study design to evaluate the efficacy of the project.
APEB’s and IFR’s long history of providing culturally sensitive HIV/AIDS care and prevention services for transgender women in the community and the extensive research experience of Nemoto’s research team in the communities have guided us to develop the proposed intervention study. Based on focus groups and input from the Community Advisory Board (CAB) and community members, we will finalize the theoretical model of the study. We will adapt the Motivational Enhancement Therapy (MET) and develop the intervention programs: Motivational Enhancement Intervention (MEI) and Brief Intervention (BI), to reduce substance abuse and HIV risk behaviors among transgender study participants. The efficacy and community impact of the interventions and theoretical model will be scientifically examined by recruiting a total 120 African American and Latina transgender women.
Specific Aims of the Study:
1. To develop an infrastructure consisting of the consortium, CAB, and transgender community members in order to develop, implement, and evaluate the intervention study, disseminate study findings and experience, and sustain the individual, organizational, and community capacities for a future full-scale intervention study.
2. To modify evidence-based intervention programs (MET) and develop, implement, and evaluate the efficacy and community impact of the intervention programs (MEI and BI) to reduce substance abuse and HIV risk behaviors among African American and Latina transgender women.
3. To examine the theoretical model and hypotheses and develop a theoretical model for a full-scale intervention study.
4. To disseminate the study findings and community collaborative efforts through publications and presentations, as well as the networks developed by the consortium, CAB, and transgender community members.
5. To develop a large scale substance abuse and HIV prevention intervention study and apply for funding in the future.