ISAP Research Projects
Name of Project: An Enhanced HIV Prevention
Intervention to Male-to-Female Transgenders
Principal Investigator: Cathy J. Reback, Ph.D.
Project Director: Mely Silverio, Ph.D.
Funding Agency: Univeristywide AIDS Research
Program (UARP)
Funding Period: November 1, 2003 - October 31,
2005
Scope of Project: Male-to-Female (MTF) transgendered
women are exposed to several socio-cultural conditions that contribute
to their risk of HIV infection, such as low income, high unemployment,
lower levels of education, and unstable housing. These transgendered
women engage in extremely high levels of injection use of hormones,
unprotected sex, sex work, and substance use. Many of the high-risk
activities in which MTF transgenders engage in, such as unmonitored
hormone use, are unique to their social circumstances and transgender
identity. The objectives of this study are: (1) to implement
an evidence-based intervention that provides enhanced HIV prevention
case management (PCM) and that delivers a set of services consistent
with the recommendations from the UARP-funded Los Angeles Transgender
Health Study; and (2) to evaluate the implementation of these
services to determine the impact of HIV prevention case management
as measured by the following outcomes: (a) reducing sex work
by facilitating legitimate employment; (b) lowering HIV injection
risks by helping transgendered women to obtain legal and monitored
hormones; (c) reducing substance abuse by helping transgendered
women with the decision to enter treatment and facilitating the
referral process when the decision for treatment is made; and
(d) reducing homelessness by helping transgendered women to obtain
stable, affordable housing. A total of 60 MTF transgenders are
being recruited to enroll in the study, which adds a high intensity
enhanced PCM intervention to a low intensity standard transgender
risk reduction program. The impact of the PCM will be assessed
using 2 methods: (1) using longitudinal models to assess the
effect of time in reducing risk behaviors and increasing access
to services and quality of life; (2) using between-group comparisons
of a sample of MTF transgenders matched on age and ethnicity
who participated in the prior Los Angeles Transgender Health
Study along outcomes that are parallel to estimate the impact
of adding PCM to the standard services. Outcomes measures include:
(a) high-risk sexual behaviors, (b) hormone misuse, (c) substance
abuse, and (d) homelessness among MTF transgenders. Correlational
analyses will be conducted to describe the sociodemographic,
behavioral, psychosocial, and psychiatric characteristics of
MTF transgenders who are best able to utilize the enhanced services.
For more information, contact Cathy J. Reback.
Last updated - 04/02/2004