Prevention case management improves socioeconomic standing and reduces symptoms of psychological and emotional distress among transgender women

Abstract

Urban transgender women often experience several sociocultural co-factors which contribute to their risk of HIV infection. A transgender-specific HIV Prevention Case Management (PCM) intervention was implemented in a community HIV prevention setting and targeted reducing sex work and homelessness, increasing legal employment and income, and reducing psychological and emotional distress symptoms. Sixty high-risk transgender women were enrolled in the ten-session PCM intervention. Participants completed approximately nine out of the ten sessions (M = 8.7; SD = 2.6) and six-month follow-up evaluations were completed with 97% of the participants. Findings from baseline to follow-up evaluations demonstrated a decrease in homelessness (31.0% vs. 10.3%, p<0.01), less reliance on exchange sex as a primary source of income (41.4% vs. 22.4%, p < 0.05), and significant decreases in symptom complaints across multiple Brief Symptom Inventory sub-scales, including depression, hostility, phobic anxiety, and psychoticism (all significant at p<0.05). Further, socioeconomic improvements following the intervention were significantly associated with psychological and emotional gains. The study suggests that adding a culturally appropriate PCM intervention in a community setting is beneficial in addressing co-factors for HIV infection as well as psychological and emotional distress symptoms among this extremely high-risk population.

Keywords:

• transgender women
• prevention case management
• comorbidity
• HIV

Acknowledgements

This study was supported by California HIV/AIDS Research Program (formerly Universitywide AIDS Research Program), grant #CR03-FRII-522 and Friends Research Institute. Funding for the HIV prevention health education/risk reduction program was provided by Los Angeles County Department of Public Health, Office of AIDS Programs and Policy, contract #H-211853-2. The authors would like to thank Jesse Fletcher, Ph.D., for his statistical support and Mely D. Silverio, Ph.D., for her work as project director during the implementation of the study and for her contribution to the development of this manuscript.