Background : In Puerto Rico (PR), TW experience verbal (35%), physical (25%), sexual (16%) violence and 51% lacked formal employment, 20% engaged in sex work, and 33% experienced discrimination for being transgender1. Twenty-five percent were discriminated for accessing social and medical services1. HIV prevalence for TW in PR is 14%2. Effective interventions are needed to empower TW and retain them in care. TWEET is an evidenced informed intervention that links TW to HIV care3. Peer leaders contact other TW living with HIV to participate in educational sessions that address topics such as HIV/AIDS and Sexually Transmitted Infections, Sexual Health, Transitioning, Wellness, and Mental Health. In PR, our culture stigmatizes people living with HIV. In a small group such as the trans community, keeping their HIV status a secret is sometimes a necessity. For this reason, TWEET was extended to HIV negative TW. If TWEET has proven to be effective for retaining TW in HIV care, would this mean that HIV negative TW could benefit as well?
Methods : A quasi-experimental one group pre and post-test design were used to measure adherence, satisfaction, and knowledge of HIV positive and negative transgender women. Pre-Exposure Prophylaxis (PrEP) referrals for HIV negative TW and the number of HIV positive TW receiving treatment was assessed. A 7-session program was developed keeping the core topics of TWEET. Incentives were given in the form of services (medical, hormonal, psychological, and nutritional services for 3 months for free.) Adherence was measured through attendance. An 11-item satisfaction questionnaire (“agree,” “neutral,” and “disagree”) and a 10-item knowledge questionnaire (“true” or “false”) were developed.
Results : The mean percentage of attendance was 94%. Overall satisfaction level for the sessions ranged from 80% to 96 %, with an 87% mean average. The level of knowledge was: 77% (pre-test) and 83% (post-test). Finally, 2 participants were referred and are currently enrolled in our PrEP program, and 6 out of 6 HIV positive TW are receiving HIV treatment.
Conclusions : Even though, this is the first TWEET track implemented on our site, encouraging statistics were obtained. Results show equal success for the TW HIV positive and the TW HIV negative groups considering adherence to the educational program, high levels of satisfaction for the educational program, knowledge increase on TWEET topics, linking HIV positive TW to care, and enrolling 2 TW to PrEP services.