Transgender women (assigned 'male'at birth with a female identity) are an understudied group with HIV prevalence rates in the range of 22 - 66%. Public health intervention research has produced no theory-driven, evidence-based interventions for transgender women. The unique cultural context of transgender women creates distinct risk factors that require systematic investigation and then integration into culturally relevant, community-based approaches to intervention. This K08 application describes a comprehensive, integrated training and research plan designed to serve as a pathway to scientific independence and the expertise to develop and test an innovative and urgently needed intervention to improve health outcomes among a highly marginalized population disproportionately affected by the HIV epidemic. The following training objectives are proposed: (1) to acquire expertise in the evaluation and application of theories of behavior change to marginalized populations;(2) to enhance skills in the use of mixed methods data collection and analysis, with an emphasis on techniques relevant to measurement development and theory testing;(3) to gain knowledge and experience with clinical trails methodology, including issues of sampling, randomization, design, protocol development, and ethics;and (4) to obtain training and experience in methods for developing, implementing, and evaluating culturally grounded, theory-driven HIV prevention interventions for transgender women. The specific research aims of the mentored original research are: (1) to describe the role of transgender women's unique cultural context on their HIV-related risk and protective factors;(2) to create new and to adapt existing quantitative measures to more accurately assess psychological dimension sand behavior relevant to transgender women's HIV risk and protective factors;(3) to identify psychosocial factors associated with HIV-related sexual and injection risk behaviors and protective factors among transgender women;and (4) to develop and test the feasibility and acceptability of a theory-driven, culturally grounded HIV prevention intervention for transgender women.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Clinical Investigator Award (CIA) (K08)
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Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Stoff, David M
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Kaplan, Rachel L; Sevelius, Jae; Ribeiro, Kira (2016) In the name of brevity: The problem with binary HIV risk categories. Glob Public Health 11:824-34
Sevelius, Jae M; Patouhas, Enzo; Keatley, Joanne G et al. (2014) Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus. Ann Behav Med 47:5-16
Sevelius, Jae M; Saberi, Parya; Johnson, Mallory O (2014) Correlates of antiretroviral adherence and viral load among transgender women living with HIV. AIDS Care 26:976-82
Sevelius, Jae M (2013) Gender Affirmation: A Framework for Conceptualizing Risk Behavior among Transgender Women of Color. Sex Roles 68:675-689
Jefferson, Kevin; Neilands, Torsten B; Sevelius, Jae (2013) Transgender women of color: discrimination and depression symptoms. Ethn Inequal Health Soc Care 6:121-136
Johnson, Mallory O; Sevelius, Jeanne M; Dilworth, Samantha E et al. (2012) Preliminary support for the construct of health care empowerment in the context of treatment for human immunodeficiency virus. Patient Prefer Adherence 6:395-404
Sevelius, Jae M; Keatley, Joanne; Gutierrez-Mock, Luis (2011) HIV/AIDS programming in the United States: considerations affecting transgender women and girls. Womens Health Issues 21:S278-82
Sevelius, Jae M; Carrico, Adam; Johnson, Mallory O (2010) Antiretroviral therapy adherence among transgender women living with HIV. J Assoc Nurses AIDS Care 21:256-64
Sevelius, Jae (2009) ""There's no pamphlet for the kind of sex I have"": HIV-related risk factors and protective behaviors among transgender men who have sex with nontransgender men. J Assoc Nurses AIDS Care 20:398-410
Sevelius, Jae M; Reznick, Olga Grinstead; Hart, Stacey L et al. (2009) Informing interventions: the importance of contextual factors in the prediction of sexual risk behaviors among transgender women. AIDS Educ Prev 21:113-27