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Integrating CBPR and Implementation Science to Develop a PrEP-Promotion Intervention for Black Transgender Women.

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Summary

This study adapted an HIV prevention intervention for Black/African American transgender women, promoting pre-exposure prophylaxis (PrEP) and condoms. The new "Sisters United" program addresses specific community needs and medical mistrust.

Keywords:
HIVhealth disparitieshealth equityinterventionsmixed methodspopulation groupsqualitative methodssexual and gender minoritiessexual healthsexually transmitted infections

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Area of Science:

  • Public Health
  • Health Equity
  • Implementation Science

Background:

  • Black/African American transgender women face high HIV rates.
  • Few evidence-based interventions are tailored to this population.
  • Existing interventions need adaptation for specific community needs.

Purpose of the Study:

  • To develop and adapt the "Sisters United" intervention for Black/African American transgender women.
  • To promote pre-exposure prophylaxis (PrEP), condom use, and gender-affirming hormone therapy (GAHT).
  • To address HIV health disparities in this community.

Main Methods:

  • Community-based participatory research and implementation science were integrated.
  • A steering committee of Black/African American transgender women and stakeholders guided the adaptation.
  • Focus groups and iterative feedback informed intervention content, including medical mistrust and injectable PrEP.

Main Results:

  • The "Sisters United" intervention was developed, including an implementation manual, facilitator guides, videos, and an e-learning course.
  • The intervention is designed for two sessions, focusing on HIV/GAHT awareness, condom skills, and healthcare access.
  • Key adaptations address medical mistrust and the use of injectable PrEP.

Conclusions:

  • "Sisters United" offers a scalable solution to promote HIV health equity among Black/African American transgender women.
  • The systematic adaptation process can guide future intervention development and refinement.
  • This work fills a critical gap in HIV prevention for a highly disproportionately affected population.