Abstract: Transgender women (TW) are currently the SGM population at highest risk for HIV infection in the United States, especially those who are racial/ethnic minorities. TW also report the highest levels of discrimination, victimization, traumatic life events, and other stressful experiences and are of the highest risk groups for substance abuse and mental health problems. HIV researchers have suggested resiliency may be a largely untapped resource in behavioral interventions and that it may be associated with reductions in mental health problems, substance abuse, and HIV related risk among marginalized populations. Daily pre-exposure prophylaxis (PrEP) is extremely effective in preventing HIV infection among those who are HIV-negative. While this is an exciting development for HIV prevention among minority TW, HIV prevention efforts must now shift focus to research on optimizing PrEP adherence among this high-risk population facing multiple recurring stressful life events and numerous structural barriers. In the proposed study, we will leverage an ongoing study of (N =300) racially and ethnically diverse TW enrolled in the Southern California based PrEP demonstration project, in order to conduct mixed-methods research, first using structural equation modeling (SEM) to assessing the risk and resiliency factors most associated with PrEP adherence among TW. Then using the SEM findings to inform follow-on, in-depth qualitative interviews with a sub-sample of high- to low-adherence minority TW to further explore those risk and resiliency factors and experiences most salient to PrEP adherence among high-risk minority TW. This study will provide the preliminary data to support the submission of an intervention development grant (NIDA R34) to develop a resilience-based intervention focused on improving PrEP adherence for TW.



Project Number: 5R21DA044073-02



Contact PI/ Project Leader








PUBLIC HEALTH RELEVANCE: Project Narrative The proposed 2-year mixed-methods study will have important scientific, clinical, and public health implications. a) Scientific: this study will advance our basic understanding of the risks and protectivefactors for PrEPadherence among transgender women (TW). b) Clinical: this study will provide the preliminary data to identify predictors of PrEPadherence and support development of a resilience-based intervention focused on improving PrEPadherence for TW. c) Public Health: findings from the proposed pilot study have major implications for future HIV intervention efforts to maximize PrEPadherence among those at highest risk for HIV, racial/ethnic minority TW.





Project Start Date: 01-May-2017

Project End Date: 30-April-2021

Budget Start Date: 01-May-2017

Budget End Date: 30-April-2021



NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE ON DRUG ABUSE / FY Total Cost by IC: $262,330