TransAction: A homegrown, theory-based, HIV risk reduction intervention for transgender women experiencing multiple health disparities.

HIV vulnerability among transgender women is symptomatic of numerous syndemic psychosocial and structural co-factors that attribute to and exacerbate HIV risk. From February 2010 to December 2017, 514 transgender women enrolled in a 'homegrown' theory-based, HIV risk reduction program, , specifically designed to intervene with trans women who experience numerous co-occurring health disparities. Increased attendance in intervention sessions was associated with significant reductions in the number of male sexual partners (coef. = -0.20), anonymous male sexual partners (-0.30), exchange male sexual partners (-0.25), engagement in drug/alcohol use (-0.37), engagement in injection drug use (-0.20), engagement in unmonitored injection hormone use (-0.55), engagement in sex while high (-0.23), and engagement in sex work (-0.20; all coefficient estimates p ≤ 0.05). Results demonstrated that the homegrown HIV risk reduction intervention was successful in working with transgender women who experience multiple co-occurring syndemic conditions. Given that there has been a dearth of evidence-based interventions for this population that are designed to be delivered in resource limited settings, can serve as a model HIV risk reduction program for guiding public health departments and community-based organizations.