Rachel L. Kaplan, PhD, MPH is a public health researcher at the Center for Research and Education on Gender and Sexuality at San Francisco State University and a postdoctoral scholar at University of California, Berkeley's Mack Center on Mental Health and Social Conflict. Dr. Kaplan's long-term career objective is to become an independent researcher specializing in the development and implementation of sexual and mental health promoting interventions among sexual minority populations in international settings. The proposed training, mentorship, and research plan support this goal and will provide her with the theoretical and practical skills necessary to become an independent intervention researcher. Although transgender women are among the most-at-risk populations for contracting HIV, few studies have been conducted to determine the most feasible and acceptable ways to impact risk. Further, knowledge of sexual and mental health among transgender women has been derived mostly from the United States. There is an urgent need for culturally relevant interventions for this marginalized population in poorly-resourced, high-stigma settings. The proposed study will address these gaps by: (1) exploring the psycho-social and cultural factors that form the context in which transgender women's sexual and mental health are situated;(2) determining how to impact transgender women's sexual and mental health through adaptation of a prevention intervention;and (3) assessing the feasibility and accessibility of the prevention intervention through pilot testing among transgender women in Lebanon. It is expected that this research will reveal prevention needs and strategies specific to transgender women in the Middle East and provide unique and powerful results to inform efficacy testing in future larger- scale trials in international settings.
This study is important to public health because it will provide critical information about how to access and engage high-risk and highly stigmatized sexual minority populations such as transgender women. Because rates of HIV transmission and mental health problems are high among transwomen, it is crucial to examine this population's sexual and mental health. Transwomen are typically marginalized;they experience high rates of gender-related abuse, unstable housing, depression, and HIV risk behavior including the engagement in sex work for income. As public health researchers, we have only begun to understand which components of existing interventions might be efficacious for risk reduction and health promotion among transwomen in the U.S. This study will investigate the cultural acceptability and feasibility of an adapted HIV prevention intervention that was originally developed for use among transwomen in the U.S. A better understanding of culturally acceptable and feasible strategies for addressing sexual and mental health among transwomen in Lebanon will aid the development and adaptation of health-promoting approaches in other international settings.