ransgender women (assigned 'male'at birth with a female identity) are an understudied group with HIV prevalence rates in the range of 22 to 68%. 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 elevant, community-based approaches to intervention. This K08 application describes a comprehensive, ntegrated 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 raining 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 trials 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 accuratelyassess psychosocial dimensions and behavior relevant to transgender women's HIV risk and protective factors;(3) to identify psychosocial factors associatedwith 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.

Public Health Relevance

Transgender women (assigned 'male'at birth but identify as female) are an understudied and highly vulnerable group, with HIV prevalence rates in the range of 22 to 68%. Due to stigma and discrimination, they may seek affirmation in ways that increase risk. This project seeks to investigate unique risk factors to develop a culturally relevant HIV prevention intervention for these high-risk women. PROJECT/PERFORMANCE SIJE(S) (if additional space is needed, use

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Clinical Investigator Award (CIA) (K08)
Project #
Application #
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Stoff, David M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
Zip Code
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; 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; 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 (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