Reducing HIV Health Disparities among African American Transgender Women: An mHealth Approach to Improving Prevention, Testing, and Treatment Outcomes

PROJECT SUMMARY ABSTRACTOne in five transgender womenTGWin the U Sis infected with HIVThe burden is particularly onerous for African AmericansWhileof U STGW are Blackover half of all new cases in TGW fromwere among African AmericansFurtherAfrican American TGW experience a complex interaction of racismsexismand transphobia that leads to health disparities across the entire spectrum of HIV related outcomesDespite the clear need for effective HIV resources designed for African American TGWno CDC defined evidence based interventionsEBIsexist for this groupWe intend to meet this need with Shinea culturallytailoredtheoretically driven mobile intervention for Black TGWThe Information Motivation Behavioral SkillsIMBmodel will guide the development of behavior change messages tailored to a user s HIV statusBeyond informationmotivationand skillsa unique socio cultural context also influences TGW s ability to perform HIV related behaviorsTo account for thiswe will contextualize the IMB based HIV content by addressing a key intrapsychic need among Black TGWgender affirmationAccording to the Model of Gender Affirmationa need for gender identity validation often leads Black TGW to engage in behaviors that run counter to HIV prevention and treatment goalsTo further improve HIV outcomesShine will teach healthy methods for gaining gender affirmationBy empowering Black TGW to affirm their gender in healthier waysthe goal is to create a context where HIV behavior change is most likely to be successfulShine will be the first mobile intervention for African American TGW that is theory basedindividuallytailoredand empoweringAll users will receive IMB based informationalmotivationaland skill building text messagesAdditional messaging will provide strategies for gaining gender affirmationThese text messages will be supplemented by three types of web based videosscripted vignettesunscripted peer narrativesand educational instructionLinks to these videos will be integrated into the messaging and will enhance the transspecific understanding of gender affirmation within our IMB frameworkAn innovative theory based HIV behavioral intervention designed to overcome the unique barriers facing African American TGWthat addresses elements across the entire HIV care continuumthat is delivered in a way that empowerseducatesand engages a stigmatized populationand that relies on a technology that is part of the everyday lives of target end users has the significant potential to meaningfully reduce HIV disparitiesSixteen African American TGW will be recruited for a focus group discussion to help shape the Shine interventionBased on what we learn from these groups and our team of consultantswe will develop a prototype mobile interventionWhen completedtheAfrican American TGW will return for usability testingThe usability test will include a series of tasks intended to highlight the features of the proposed interventionThree usability metrics will be assessedefficiencyaccuracyand subjective satisfaction PROJECT NARRATIVE This project aims to develop a culturally tailored mHealth HIV behavioral intervention for African American transgender womenIt will allow clinics and community based organizations to provide an empoweringmobileand empirically validated HIV behavioral intervention to their transgender clients without creating additional demands on their already overburdened staffThe information and skills contained within this intervention will help African American transgender women of any HIV statusHIV negativeHIV positiveor unknownachieve better HIV related health outcomes