Many male-to-female transgender women are at high-risk of HIV infection as a result of several socio-cultural conditions, such as low income, high unemployment, lower levels of education, and unstable housing. Economic necessity, as a result of severe unemployment and housing discrimination, results in a reliance on sex work to secure food, shelter, and money.
The TransAction Program provides culturally appropriate, evidence based HIV prevention services that address both individual and socio-cultural risk factors. The program offers a multi-tier health education and risk reduction (HE/RR) intervention – utilizing both individual and group-delivered interventions – designed to reduce high-risk sexual and drug behaviors among transgender women. Most specifically the intervention target risk behaviors that are specific to the socio-cultural circumstances of high-risk transgenders, particularly exchange sex, hormone misuse, injection and non-injection drug risks. The program consists of a comprehensive, culturally appropriate, continuum of services that includes outreach encounters, individual-delivered interventions (IDI), skills building group-delivered interventions (GDI) and support groups.
Follow-up IDI assessments are conducted at 30, 60 and 90 days. Face-to-face street outreach is conducted in identified high-risk areas of Hollywood, West Hollywood and downtown Los Angeles and in the natural settings where high-risk transgender women congregate. The skills building GDI component of the intervention serves to increase knowledge and awareness of HIV risk behaviors and develop skills to decrease HIV risk behaviors. Concurrently, the support GDI component of the intervention serves to increase social support and self-esteem. Both the skills building GDI and support GDI – working concomitantly with the outreach encounters and IDI – motivate ongoing and maintained HIV risk reductions and gear participants’ towards HIV testing to identify their HIV status and, finally, develop skills for disclosing HIV status.
The TransAction Skills Building Groups