Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative

S. Hirshfield; J. Contreras; R. Q. Luebe; J. A. Swartz; R. Scheinmann; C. J. Reback; J. B. Fletcher; K. A. Kisler; L. M. Kuhns; L. F. Molano

doi:10.1007/s10461-019-02667-6

Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative

S. Hirshfield^*, J. Contreras, R. Q. Luebe, J. A. Swartz, R. Scheinmann, C. J. Reback, J. B. Fletcher, K. A. Kisler, L. M. Kuhns, L. F. Molano

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

24 Scopus citations

Abstract

Transgender women (TW) have higher HIV prevalence rates than cisgender (i.e., non-transgender) women. However, utilization of healthcare for transgender people in the U.S. is low. As part of a multisite initiative to facilitate entry and retention in HIV care for TW of color, we compared health outcomes between participants who became Peer Leaders and those who did not. From 2013 to 2016, 163 New York City, mostly Latina, TW enrolled in the Transgender Women Engagement and Entry to Care Project (TWEET). The TWEET intervention included peer-led, group-based educational sessions called Transgender Leader—Teach Back; 39% completed Peer Leadership requirements. Comparing pre-post change by Peer Leader status, Peer Leaders had a significant decrease in viral load and significant increase in CD4 at the last HIV care visit compared to the first. In multivariable logistic regression, predictors associated with Peer Leadership included having at least some college education, being in a relationship, stable housing, receiving legal assistance for political asylum, and having two or more HIV care visits during the intervention. Findings suggest that, for trans women who have completed at least secondary school education, participating in a peer-led intervention can lead to improved HIV care engagement. Understanding which program components lead to becoming a Peer Leader, and how to better engage non-Peer Leaders, are important next steps.

Original language	English (US)
Pages (from-to)	20-30
Number of pages	11
Journal	AIDS and behavior
Volume	25
DOIs	https://doi.org/10.1007/s10461-019-02667-6
State	Published - Jul 2021

Funding

This publication was made possible by the US Department of Health and Human Services, Health Resources and Services Administration (HRSA; cooperative Agreement Number U90HA24973). This SPNS initiative was critical to the goal of improving health outcomes for TW of color living with HIV. Community Healthcare Network’s high level of commitment and community involvement also led to the success of this intervention. We would like to thank Ariana Beatty, Steven T. Houang, and Martin J. Downing for their assistance with research and data analysis. Note. The content is solely the responsibility of the authors and does not represent the official views of the Health Resources and Services Administration or the US Department of Health and Human Services.

Keywords

HIV
Intervention
Peer Leader
Political asylum
Transgender

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10461-019-02667-6

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Hirshfield, S., Contreras, J., Luebe, R. Q., Swartz, J. A., Scheinmann, R., Reback, C. J., Fletcher, J. B., Kisler, K. A., Kuhns, L. M., & Molano, L. F. (2021). Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative. AIDS and behavior, 25, 20-30. https://doi.org/10.1007/s10461-019-02667-6

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title = "Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative",

abstract = "Transgender women (TW) have higher HIV prevalence rates than cisgender (i.e., non-transgender) women. However, utilization of healthcare for transgender people in the U.S. is low. As part of a multisite initiative to facilitate entry and retention in HIV care for TW of color, we compared health outcomes between participants who became Peer Leaders and those who did not. From 2013 to 2016, 163 New York City, mostly Latina, TW enrolled in the Transgender Women Engagement and Entry to Care Project (TWEET). The TWEET intervention included peer-led, group-based educational sessions called Transgender Leader—Teach Back; 39\% completed Peer Leadership requirements. Comparing pre-post change by Peer Leader status, Peer Leaders had a significant decrease in viral load and significant increase in CD4 at the last HIV care visit compared to the first. In multivariable logistic regression, predictors associated with Peer Leadership included having at least some college education, being in a relationship, stable housing, receiving legal assistance for political asylum, and having two or more HIV care visits during the intervention. Findings suggest that, for trans women who have completed at least secondary school education, participating in a peer-led intervention can lead to improved HIV care engagement. Understanding which program components lead to becoming a Peer Leader, and how to better engage non-Peer Leaders, are important next steps.",

keywords = "HIV, Intervention, Peer Leader, Political asylum, Transgender",

author = "S. Hirshfield and J. Contreras and Luebe, \{R. Q.\} and Swartz, \{J. A.\} and R. Scheinmann and Reback, \{C. J.\} and Fletcher, \{J. B.\} and Kisler, \{K. A.\} and Kuhns, \{L. M.\} and Molano, \{L. F.\}",

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year = "2021",

month = jul,

doi = "10.1007/s10461-019-02667-6",

language = "English (US)",

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Hirshfield, S, Contreras, J, Luebe, RQ, Swartz, JA, Scheinmann, R, Reback, CJ, Fletcher, JB, Kisler, KA, Kuhns, LM & Molano, LF 2021, 'Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative', AIDS and behavior, vol. 25, pp. 20-30. https://doi.org/10.1007/s10461-019-02667-6

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T1 - Engagement in HIV Care Among New York City Transgender Women of Color

T2 - Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative

AU - Hirshfield, S.

AU - Contreras, J.

AU - Luebe, R. Q.

AU - Swartz, J. A.

AU - Scheinmann, R.

AU - Reback, C. J.

AU - Fletcher, J. B.

AU - Kisler, K. A.

AU - Kuhns, L. M.

AU - Molano, L. F.

PY - 2021/7

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N2 - Transgender women (TW) have higher HIV prevalence rates than cisgender (i.e., non-transgender) women. However, utilization of healthcare for transgender people in the U.S. is low. As part of a multisite initiative to facilitate entry and retention in HIV care for TW of color, we compared health outcomes between participants who became Peer Leaders and those who did not. From 2013 to 2016, 163 New York City, mostly Latina, TW enrolled in the Transgender Women Engagement and Entry to Care Project (TWEET). The TWEET intervention included peer-led, group-based educational sessions called Transgender Leader—Teach Back; 39% completed Peer Leadership requirements. Comparing pre-post change by Peer Leader status, Peer Leaders had a significant decrease in viral load and significant increase in CD4 at the last HIV care visit compared to the first. In multivariable logistic regression, predictors associated with Peer Leadership included having at least some college education, being in a relationship, stable housing, receiving legal assistance for political asylum, and having two or more HIV care visits during the intervention. Findings suggest that, for trans women who have completed at least secondary school education, participating in a peer-led intervention can lead to improved HIV care engagement. Understanding which program components lead to becoming a Peer Leader, and how to better engage non-Peer Leaders, are important next steps.

AB - Transgender women (TW) have higher HIV prevalence rates than cisgender (i.e., non-transgender) women. However, utilization of healthcare for transgender people in the U.S. is low. As part of a multisite initiative to facilitate entry and retention in HIV care for TW of color, we compared health outcomes between participants who became Peer Leaders and those who did not. From 2013 to 2016, 163 New York City, mostly Latina, TW enrolled in the Transgender Women Engagement and Entry to Care Project (TWEET). The TWEET intervention included peer-led, group-based educational sessions called Transgender Leader—Teach Back; 39% completed Peer Leadership requirements. Comparing pre-post change by Peer Leader status, Peer Leaders had a significant decrease in viral load and significant increase in CD4 at the last HIV care visit compared to the first. In multivariable logistic regression, predictors associated with Peer Leadership included having at least some college education, being in a relationship, stable housing, receiving legal assistance for political asylum, and having two or more HIV care visits during the intervention. Findings suggest that, for trans women who have completed at least secondary school education, participating in a peer-led intervention can lead to improved HIV care engagement. Understanding which program components lead to becoming a Peer Leader, and how to better engage non-Peer Leaders, are important next steps.

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KW - Intervention

KW - Peer Leader

KW - Political asylum

KW - Transgender

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SN - 1090-7165

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ER -

Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative

Abstract

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Keywords

ASJC Scopus subject areas

UN SDGs

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