Trans Women Connected: a mobile app delivered sexual health promotion program

ABSTRACT: , Trans Women Connected: a mobile app delivered sexual health promotion program
During the past two decades, the HIV epidemic has severely impacted transgender women in the U.S. According
to the CDC persons have the highest HIV incidence of any risk group (56% of Black transgender women are
living with HIV), and discrepancies between self-reported prevalence and HIV testing data indicate that many
HIV-infected transgender women are not aware of their HIV status. Other public health conditions among
transgender women include discrimination-based physical and verbal abuse, poor mental health, alcohol and
drug use, and unmet health care needs resulting from limited healthcare access and negative healthcare
encounters. These co-occurring problems additively increase sexual risk for transgender women. Despite these
health disparities and health-care access barriers, the U.S. National HIV/AIDS Strategy notes that HIV prevention
efforts specifically targeting transgender populations have been minimal, leaving a dearth of evidence-based
programs that address the unique needs of transgender women, leaving practitioners to implement programs
designed for men who have sex with men (MSM) or cisgender women, even though transgender womenandapos;s
experiences of gender abuse, gender transition, transactional sex and violence distinguish them from most MSM
and cisgender women. This project will address these gaps by completing the development of Trans Women
Connected: A Sexual Health Promotion Mobile App designed to engage transgender women through a
strengths-based approach to HIV/sexual health that uses the power of social networks to identify and encourage
protective factors that support the health and well-being of transgender women. Based on the needs of
transgender women identified during Phase I research the app will focus heavily on sexual health/harm
reduction, identity affirmation, structural issues impacting health, and connectedness. At the end of Phase II the
mobile delivered intervention will expand the HIV prevention opportunities for transgender women by (1)
providing organizations a cost-effective and easily implementable intervention option that is specifically designed
for transgender women; (2) not requiring participants to attend multiple face-to-face sessions in a physical
location and instead support iterative intervention implementation at any time or place; (3) permit transgender
women to anonymously view the program on their phone in private settings; and (4) offer an effective means for
transgender women to connect with each other and providers via mobile technology. The Phase I project
demonstrated feasibility in creating an app that changed knowledge and intentions of users with just three
activities, while being appealing to the target audience. Phase II will complete the development of the app with
40+ activities, a forum/messaging system for social support/connection, all developed with input from panels of
experts and community members. A randomized controlled will assess the effectiveness of the app using a
number of measures including STI prevention, improvement in health care seeking, perceived social support.PUBLIC HEALTH NARRATIVE
During the past two decades, the HIV epidemic has severely impacted transgender women in the United States.
Transgender persons have the highest HIV incidence of any risk group, and discrepancies between self-reported
prevalence and HIV testing data indicate that many HIV-infected transgender women are not aware of their HIV
status. The U.S. National HIV/AIDS Strategy notes that transgender persons are at high risk for HIV infection
and yet efforts specifically targeting transgender populations have been minimal. In addition, transgender women
are at increased risks for sexual violence, mental health problems, and they are hindered by a lack of access to
trans-friendly competent health care. To date there are limited HIV prevention/sexual health promotion programs
that have been developed for and evaluated with this population. To fill this unmet need this project will develop
a mobile app delivered multimedia interactive HIV prevention and sexual health promotion program developed
for transgender women that delivers the intervention as a series of interactive activities tailored to the user.
Activities include those focused on sexual health, health, infrastructure constraints, and connectedness to other
transgender women. When complete, the resulting resource will provide a cost effective HIV/STI intervention
that can be implemented with transgender women across diverse settings with fidelity, while increasing uptake
and effective delivery by appealing to the target audience on their mobile device and ultimately reducing new
HIV/STI infections and improving health among transgender women.