Sexuality Research and Social Policy

, Volume 16, Issue 4, pp 408–418 | Cite as

TransAction: A Homegrown, Theory-Based, HIV Risk Reduction Intervention for Transgender Women Experiencing Multiple Health Disparities

  • Cathy J. RebackEmail author
  • Kirsty Clark
  • Jesse B. Fletcher


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, TransAction, specifically designed to intervene with trans women who experience numerous co-occurring health disparities. Increased attendance in TransAction 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, TransAction can serve as a model HIV risk reduction program for guiding public health departments and community-based organizations.


Transgender HIV Health disparities Risk reduction 



This study was supported by the Los Angeles County, Department of Public Health, Division of HIV and STD Programs (formerly Office of AIDS Programs and Policy) contract PH#001039. Dr. Reback acknowledges additional support from the National Institute of Mental Health (P30 MH58107). The authors thank the staff who facilitated the TransAction program, most particularly Ms. April Saravia, for their dedication and service to the trans women in Los Angeles County.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

As outlined in the HHS Office for Protection from Research Risks guidance, the data collected for this manuscript were part of a service program and, thus, exempt from IRB review.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Friends Research Institute, Inc.Los AngelesUSA
  2. 2.Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human BehaviorUniversity of CaliforniaLos AngelesUSA
  3. 3.Center for HIV Identification, Prevention and Treatment ServicesUniversity of CaliforniaLos AngelesUSA
  4. 4.Department of Epidemiology, Fielding School of Public HealthUniversity of CaliforniaLos AngelesUSA

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