Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: HIV prevalence within the diverse male to female (MtF) transgender population in the United States is estimated to range from 11% to 78%. Despite being considered an emerging population for HIV infection, little knowledge exists about the Hispanic/ Latino MtF community. The Transgender Intervention & Intervention Services (TIPS) project is a targeted HIV/AIDS prevention program in South Beach. The key service delivery components of TIPS are: 1) the Popular Opinion Leader (POL) model and 2) the Rapid Testing Project (RTP). This mixed-method study: 1) Creates a demographic and risk profile of Latina MtF and 2) Evaluates the relationship of POL outreach activities on rapid HIV testing.

Methods: Measures of HIV knowledge, risk behaviors and basic demographics were obtained from MtF RTP records (n=87). SPSS was utilized to generate descriptive statistics and construct MtF risk profiles and testing patterns. Purposive sampling techniques recruited participants for three voluntary focus groups (n=24). Semi-structured interview protocols included participants' behavior change, safe sex and response to intervention. Data were transcribed verbatim and analyzed using Atlas-Ti, grounded theory and multistage coding. Using the constant comparative method two independent coders ensured inter-rater reliability with 90% code agreement. Rigor was achieved through Lincoln and Gubas (1985) trustworthiness standards.

Results: The MtF individuals and their primary partners that were tested as a result of the TIPS outreach program were primarily Latina immigrants that had never been tested (95.6%). Staggering risk profiles included high rates of unprotected sexual activity (96.4%) and trading sex for money/ drugs or things (42%) within the past twelve months. The mean number of partners for each MtF tested was 116.27. Other significant risks include “silicone parties” where Mtf consume alcohol and drugs to alleviate the pain of silicone injections to feminize the body. The majority (92.8%) of these testing were referred through TIPS outreach activities. Qualitative analysis of the focus groups found emerging themes: 1) Multiple health risks; 2) Increased consciousness; 3) Acceptance; 4) Increased HIV Testing and the 5) Ending of silence.

Implications for Practice: The fusion of public health and social work disciplines is particularly vital to HIV prevention efforts in vulnerable populations. Through a public health perspective that incorporates education, community partnerships, advocacy and monitoring, social work and cultural competencies will be addressed. MtF Latinas engage in numerous risk behaviors and have few sources of HIV/AIDS preventative care. The recognition that HIV/AIDS may not be a high priority for transgender Latinas because of other pressing health concerns combined with a lack of accurate HIV/AIDS knowledge may impact research and prevention efforts. Recruitment and outreach strategies for research within transgender populations will be discussed. Recommendations will be offered to increase HIV testing among hard to reach minority transgender populations in a time of reduced resources.