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Evaluation of Translife Care: An Intervention to Address Social Determinants of Engagement in HIV Care Among Transgender Women of Color

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Abstract

The TransLife Care (TLC) project was developed to address the structural factors that act as barriers to HIV care among transgender women of color. The purpose of this study was to evaluate the feasibility and initial efficacy of the TLC project; primary HIV care outcomes included linkage to HIV care, engagement in care, retention in care, use of ART and viral suppression among N = 120 participants. In multivariable analysis, receipt of the intervention (versus none), was associated with any HIV care visit (aOR 2.05; 95% CI 1.25–3.37; p = 0.005), more total HIV care visits (aRR 1.45; 95% CI 1.09–1.94; p = 0.011), being retained in care (aOR 1.58; 95% CI 1.03–2.44; p = 0.038), and having a viral load test done (aOR 1.95; 95% CI 1.23–3.09; p = 0.004). We conclude that a structural intervention, designed and delivered by the focus population, that directly addresses social determinants, is feasible and efficacious to promote HIV care engagement among transgender women of color.

Resumen

El proyecto TransLife Care (TLC) se desarrolló para abordar los factores estructurales que actúan como barreras para la atención médica del VIH entre las mujeres transgénero de color. El propósito de este estudio fue evaluar la viabilidad y la eficacia inicial del proyecto TLC; los resultados primarios de la atención médica del VIH incluyeron el vínculo con la atención médica del VIH, la retención en la atención médica, el uso de ART y la supresión viral entre N = 120 participantes. En el análisis multivariable, la recepción de la intervención (versus ninguna) se asoció con la participación en la atención médica (aOR 2.05, IC 95% 1.25–3.37, p = 0.005), más visitas totales al VIH (aRR 1.45, IC 95% 1.09–1.94, p = 0.011), se mantuvo en la atención médica (aOR 1.58; IC 95%: 1.03 - 2.44; p = 0.038) y se realizó una prueba de carga viral (aOR 1.95; IC 95%: 1.23 - 3.09; p = 0.004). Concluimos que una intervención estructural, diseñada y ejecutada por la población de enfoque, que aborda directamente los determinantes sociales, es factible y eficaz para promover el compromiso de la atención del VIH entre las mujeres transgénero de color.

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Acknowledgements

We thank members of the TLC Team for their contribution to sample accrual and data collection. Thanks also to our community health partner, Heartland Alliance Health. Research reported in this publication was supported by Award Number H97HA24965 from the HRSA to Chicago House and Social Service Agency. The content is solely the responsibility of the authors and does not necessarily represent the official views of HRSA.

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Authors and Affiliations

  1. Division of Adolescent Medicine, Ann & Robert H. Lurie Children’s Hospital, 225 E. Chicago Avenue, Box 161, Chicago, IL, 60611, USA

    Lisa M. Kuhns, Abigail L. Muldoon, Amy K. Johnson & Robert Garofalo

  2. Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Lisa M. Kuhns, Amy K. Johnson & Robert Garofalo

  3. Department of Medicine, University of Chicago, Chicago, IL, USA

    Anna L. Hotton

  4. Chicago House and Social Service Agency, Chicago, USA

    Judy Perloff, Josie Paul & Channyn Parker

Authors
  1. Lisa M. Kuhns
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  2. Anna L. Hotton
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  3. Judy Perloff
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  4. Josie Paul
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  5. Channyn Parker
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  6. Abigail L. Muldoon
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  7. Amy K. Johnson
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  8. Robert Garofalo
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Correspondence to Lisa M. Kuhns.

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Kuhns, L.M., Hotton, A.L., Perloff, J. et al. Evaluation of Translife Care: An Intervention to Address Social Determinants of Engagement in HIV Care Among Transgender Women of Color. AIDS Behav 25 (Suppl 1), 13–19 (2021). https://doi.org/10.1007/s10461-019-02548-y

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