Transwomen Connected, a mobile app delivered HIV prevention program - ABSTRACT
Transwomen Connected: a mobile app delivered HIV prevention program
During the past two decades, the HIV epidemic has severely impacted transgender women in the U.S. Analysis
of 2013 national HIV testing data found that 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. 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. In particular, there are no transgender-specific, evidence-
based programs that address the unique prevention needs of transgender women, leaving practitioners to
implement programs designed for men who have sex with men (MSM) or cisgender women, even though
transgender women'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 and fill an important product
niche by testing the feasibility of creating Transwomen Connected: A Sexual Health Promotion Mobile App
designed to engage transgender women through a strengths-based approach to HIV prevention and 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. 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 practitioners and agencies with low levels of technological infrastructure an effective means
to connect with clients via mobile technology. The Phase I project, guided by an expert panel of transgender
women of color, will produce: extensive formative research; a complete curriculum outline developed using a
holistic, sexual harm reduction and life skills framework based on Social Cognitive Theory, gender affirmation,
social support, and resilience; a prototype mobile app with complete app design, architecture, and three
activities; and a usability evaluation to determine usability, appeal, and impact on knowledge and attitudes.
Phase II will complete development and conduct a multi-site randomized controlled trial to assess effectiveness.
