Principal Investigator: Cathy J. Reback, Ph.D.
Funded By: Los Angeles County, Department of Public Health, Division of HIV and STD Programs
Grant #: PH-001039
Total Project Period: 10/1/06 – 6/30/20

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 intervention – utilizing both individual and group-level interventions – designed to reduce high-risk sexual and drug behaviors among transgender women. Most specifically the interventions will 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-level interventions (ILI), skills building group-level interventions (GLI)s and support GLIs. Follow-up ILI assessments will be conducted at 30, 60 and 90 days. Face-to-face street outreach is conducted in identified high-risk areas of Hollywood and West Hollywood and in the natural settings where high-risk transgender women congregate. The skills building GLI 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 GLI component of the intervention serves to increase social support and self-esteem. Both the skills building GLI and support GLI – working concomitantly with the outreach encounters and ILI – 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.