Date of Award

Spring 2020

Degree Name

Bachelor of Science

Department

Community & Global Public Health; College of Health Sciences

First Advisor

Comfort Olorunsaiye

Abstract

HIVanish: A Program Addressing HIV Rates in Transgender Sex Workers in Washington D.C.

Evangeline Wang

Faculty Advisor: Dr Olorunsaiye

As of 2013 around 16, 500 residents in Washington D.C. were living with HIV. Of the 16,500 residents, 1.5% or 246 cases were among the transgender population. The majority of those cases were among transgender women at 67.5%1. Gaps remain in addressing HIV among transgender sex workers, most of them on a systemic level. This could be attributed to misclassification of transgender women as men who have sex with men, or systemic neglect2. This lack of knowledge stems from limited research because only 0.1% of funding from the NIH goes toward LGBTQ+ issues and less than 7% of that funding addresses the transgender population. Moreover, stigma surrounds HIV and gender identity which can deter transgender sex workers (TSWs) from accessing primary care for fear of discrimination3. HIVanish aims to address these gaps through a grassroots level.

HIVanish will target the transgender sex worker community in Washington D.C. to provide comprehensive, culturally sensitive health care to TSWs through a mobile health clinic, health care facility, and peer-led educational sessions. Goals and objectives are to minimize risky behaviors in TSWs in Washington D.C. through increasing needle distribution and knowledge surrounding HIV4 and reducing HIV incidence among TSWs in Washington D.C. by increasing screenings and condom distribution4. The program duration is from January 2021 to January 2022. Receiving appropriate ethical approval and recruitment of peer leaders would happen within the first two months. Training of staff, volunteers, and interns will happen in the first 3 months and follow up trainings on month 6 and month 10. Peer-led educational sessions will occur from month 3-11 with evaluations on months 3, 6, and 12. A monthly stipend payment to peer leaders occur from months 3-12. Provision of services from the mobile health clinic will happen in months 3-11. The total requested funds for HIVanish is $479,272. Requested funds for the senior personnel for the year is $86,750, other personnel totals $31,750, fringe benefits at $23,770, equipment and equipment maintenance at $240,930, cost of travel at $1,740, participants cost totals $4,000, and other direct costs come to $8,385.

The survey assessment will compare condom utilization before the peer-led groups and then at six months and lastly at one year. Individuals using a condom during every sexual act during the session will be marked as 100% condom use. 100% lubricant use will be defined as water or silicon based lubricant used during anal sex. Linkage to care will be measured in the final posttest. The proposed intervention will be successful if clients are linked to care and retained. Needle distribution will be considered effective if the number of exchanges is equal or more. Condom distribution will be considered effective if HIVanish distributes 500,000 condoms. Success of peer led groups will be measured if over 70% of clients demonstrate an increased understanding of harm reduction and safer sex strategies through a pre-and post-test.

Program outcomes will be disseminated in an end-of-year brief using qualitative and quantitative data. Key stakeholders like grant makers, board of directors, program participants, D.C. Department of Health, and other health clinics can access the information through an email sent to the appropriate contact persons. If possible, meetings will be held with each key stakeholder group to update them on program success.

HIVanish helps provide comprehensive and culturally sensitive health care to TSWs to reduce HIV transmission rates. Until systematic policy changes address healthcare gaps among vulnerable populations, HIVanish will continue to serve TSWs in D.C. through using grants and partnerships with other organizations.

Additional Files

Project_Overview_WANG.pdf (34 kB)

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HIVanish: A PROGRAM ADDRESSING HIV RATES IN TRANSGENDER SEX WORKERS IN WASHINGTON D.C.

HIVanish: A Program Addressing HIV Rates in Transgender Sex Workers in Washington D.C.

Evangeline Wang

Faculty Advisor: Dr Olorunsaiye

As of 2013 around 16, 500 residents in Washington D.C. were living with HIV. Of the 16,500 residents, 1.5% or 246 cases were among the transgender population. The majority of those cases were among transgender women at 67.5%1. Gaps remain in addressing HIV among transgender sex workers, most of them on a systemic level. This could be attributed to misclassification of transgender women as men who have sex with men, or systemic neglect2. This lack of knowledge stems from limited research because only 0.1% of funding from the NIH goes toward LGBTQ+ issues and less than 7% of that funding addresses the transgender population. Moreover, stigma surrounds HIV and gender identity which can deter transgender sex workers (TSWs) from accessing primary care for fear of discrimination3. HIVanish aims to address these gaps through a grassroots level.

HIVanish will target the transgender sex worker community in Washington D.C. to provide comprehensive, culturally sensitive health care to TSWs through a mobile health clinic, health care facility, and peer-led educational sessions. Goals and objectives are to minimize risky behaviors in TSWs in Washington D.C. through increasing needle distribution and knowledge surrounding HIV4 and reducing HIV incidence among TSWs in Washington D.C. by increasing screenings and condom distribution4. The program duration is from January 2021 to January 2022. Receiving appropriate ethical approval and recruitment of peer leaders would happen within the first two months. Training of staff, volunteers, and interns will happen in the first 3 months and follow up trainings on month 6 and month 10. Peer-led educational sessions will occur from month 3-11 with evaluations on months 3, 6, and 12. A monthly stipend payment to peer leaders occur from months 3-12. Provision of services from the mobile health clinic will happen in months 3-11. The total requested funds for HIVanish is $479,272. Requested funds for the senior personnel for the year is $86,750, other personnel totals $31,750, fringe benefits at $23,770, equipment and equipment maintenance at $240,930, cost of travel at $1,740, participants cost totals $4,000, and other direct costs come to $8,385.

The survey assessment will compare condom utilization before the peer-led groups and then at six months and lastly at one year. Individuals using a condom during every sexual act during the session will be marked as 100% condom use. 100% lubricant use will be defined as water or silicon based lubricant used during anal sex. Linkage to care will be measured in the final posttest. The proposed intervention will be successful if clients are linked to care and retained. Needle distribution will be considered effective if the number of exchanges is equal or more. Condom distribution will be considered effective if HIVanish distributes 500,000 condoms. Success of peer led groups will be measured if over 70% of clients demonstrate an increased understanding of harm reduction and safer sex strategies through a pre-and post-test.

Program outcomes will be disseminated in an end-of-year brief using qualitative and quantitative data. Key stakeholders like grant makers, board of directors, program participants, D.C. Department of Health, and other health clinics can access the information through an email sent to the appropriate contact persons. If possible, meetings will be held with each key stakeholder group to update them on program success.

HIVanish helps provide comprehensive and culturally sensitive health care to TSWs to reduce HIV transmission rates. Until systematic policy changes address healthcare gaps among vulnerable populations, HIVanish will continue to serve TSWs in D.C. through using grants and partnerships with other organizations.

 
 

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