HIV Prevention Among Latina Transgender Women Who Have Sex With Men: Evaluation of a Locally Developed Intervention

ChiCAS will be delivered as two 4-hour group sessions over a period of two weeks to groups of
about 10 participants at seven community-based organizations (CBOs) in five metropolitan
locations in North Carolina (Asheville, Charlotte, Greensboro/Winston-Salem, Raleigh/Durham
and Wilmington).

The intervention will be evaluated by comparing women randomized to the ChiCAS intervention
group to those randomized to the delayed-intervention (waitlist) comparison group. As many as
140 participants (as many 70 participants per arm) in total will be recruited to the study.
All participants will complete identical quantitative assessments at baseline and 6-month
follow up. Baseline and 6-month follow-up data collection will include the following
measures:

Outcome variables:

Use of PrEP and medically supervised hormone therapy and consistent condom use.

Demographics:

Age, current living situation, marital/partner status, education, country and region of
origin, ethnicity/race, work and work patterns and history, financial status (including
income, numbers of persons income supports), number of children and adults living in
household, gender identity; time in the US and NC; Spanish-language literacy;
English-language skills; health insurance; documentation status.

Mediating variables:

Knowledge about HIV and STDs: types of diseases, modes of transmission, signs, symptoms,
prevention strategies, and their magnitude within communities; condom use-related attitudes,
skills, self-efficacy, and intentions; adherence to traditional Latino values of masculinity
and fatalism; transphobia; ethnic group pride; knowledge of available transition-related
services, how to access, what to expect, and eligibility; barriers to seeking healthcare
services, for HIV testing, PrEP, or transition-related services; perceived access to health
care; social support; substance use; substance use during sex; communication skills with
partners and providers; provider trust.

Other variables:

Religiosity; mental health, perceived discrimination; community attachment; foregoing unsafe
sex/episodic abstinence HIV and sexually transmitted disease (STD) history; victimization;
sexual compulsivity; sex for money, drugs or shelter, self-reported health status,
acculturation, community attachment, technology use, HIV and STD history

A qualitative interview will be administered to 30 randomly selected participants after they
complete the 6-month follow-up assessments. Three groups of ten participants each will be
interviewed to identify factors associated with each of the following outcome patterns:

1. Participants who reported an increase in at least one HIV prevention behavioral outcome
(PrEP or condom use) and who reported an increase in the use of medically supervised
hormone therapy (n=10);

2. Participants who did not report an increase in at least one HIV prevention behavioral
outcome (PrEP or condom use) and did not report an increase in the use of medically
supervised hormone therapy (n=10), and

3. Participants with mixed results (n=10).

Inclusion Criteria:

1. Self-identify as male-to-female transgender or report having been born male and
identifying as female;

2. Self-identify as Hispanic or Latina;

3. Are ≥ 18 years of age;

4. Report sex with at least 1 man in the past 6 months;

5. Are HIV negative (based on self-report and verification by HIV testing);

6. Are fluent in Spanish; and

7. Provide informed consent.

Exclusion Criteria:

(a) Having participated in any HIV prevention intervention within the past 12 months,
including Chicas or other interventions co-developed by Wake Gorest University (HOLA en
Grupos or HOLA).

- Are ≥ 18 years of age;