Community-Engaged Structural Approaches to Prevent Violence and Improve HIV Prevention and Care Outcomes Among Trans Women of Color - PROJECT ABSTRACT
This K01 application to NIMH will enable a concentrated four-year intensive training and mentored
research program designed to transition Dr. Sarah Peitzmeier from her current observational research focus to
a new research agenda designing and evaluating structural interventions within a community-based
participatory research (CBPR) context for integrated HIV and violence prevention and mental health promotion,
in partnership with trans women of color. Dr. Peitzmeier is an assistant professor at the University of Michigan
School of Nursing and School of Public Health, which houses one of the oldest CBPR partnerships and
academies nationally (the Detroit Urban Research Center) and is a powerhouse of HIV intervention research.
Racism, sexism, HIV stigma, cisgenderism, and other interlocking forms of oppression generate
mutually reinforcing structural vulnerabilities for trans women of color, including gender-based violence (GBV),
poverty, homelessness, and sex work. These structural vulnerabilities synergistically interact to elevate risk of
HIV. However, interventions to address these deeply entrenched upstream structural determinants of HIV in
this population are limited, which in turn limits the efficacy of downstream individual behavioral interventions
while these determinants remain intact. The proposed work will 1) Identify community priorities for a structural
intervention for integrated HIV/GBV prevention through forming a CBPR partnership with trans women of color
and service providers in Detroit and conducting an Action-Oriented Community Diagnosis, 2) Develop a
grounded theory of how trans women's participation in a cash-plus cash transfer intervention affects their
experience of GBV, HIV-related behaviors, and mental health, and 3) Collaboratively design a status-neutral
intervention to promote HIV prevention and care, reduce mental health burden, and prevent GBV against trans
women of color.
The research will be underpinned by coursework in CBPR, structural interventions, intervention trial
design, and implementation science, as well as invaluable mentored learning experiences observing the
implementation and evaluation of diverse structural interventions (Drs. Darbes, Sherman, Gamarel, and
Pettifor) and CBPR partnerships (Gamarel, Israel, Brush, Rivera) from renowned experts in the field. Overall,
the research will generate rich preliminary data, a finalized intervention protocol, a concrete strategy for
funding and implementing the intervention, a pilot hybrid efficacy-implementation trial design for evaluating the
intervention, and a strong CBPR partnership as a fruitful platform for Dr. Peitzmeier's ongoing research agenda
in partnership with this community. By supporting didactic and field-based learning and protected time for
research and CBPR partnership building, a K01 will advance Dr. Peitzmeier's career progression as an
independent, community-based HIV intervention scientist focused on structural determinants of health, leading
to better health and wellbeing among trans women of color, an NIH priority population.