Strengthening community responses to economic vulnerability and HIV inequities

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ABSTRACT In the United States, transgender women of color (`trans women of color') experience cyclical, interlocking systems of structural and institutional oppression rooted in racism and transphobia, which fuel economic vulnerability. Together, cycles of intersecting racism, transphobia, and economic vulnerability create conditions that give rise to extreme HIV inequities among trans women of color. Microeconomic interventions – designed to improve financial standing by increasing income generation and access to financial resources through entrepreneurship, cash transfers, and training — have the potential to address structural factors underlying HIV risk. Over the past few years, several trans-led organizations, including the Trans Sistas of Color Project, have integrated microeconomic strategies, specifically emergency assistance (i.e., unconditional cash grants) into their programming. Building on our formative work in Detroit, this project seeks to adapt and examine the acceptability and feasibility of an enhanced microeconomic intervention designed to address HIV prevention and care continua outcomes. The enhanced microeconomic intervention builds on our community partner's existing microeconomic interventions, which includes: (1) an emergency assistance; and (2) peer and legal support to obtain legal gender affirmation (i.e., legal name and gender markers on identification documents). The existing intervention will be enhanced to include (1) weekly educational sessions on economic empowerment (i.e., job acquisition, income generation through micro-business, and financial literacy) and HIV prevention and care; (2) employment-focused mentoring; (3) weekly social media posts of job openings in Detroit; and (4) an unconditional grant ($1,200) for use towards acquiring self-led or formal employment. Our community advisory board composed of trans women of color will provide ongoing consultation. The proposed research plan is directly in line with the prioritization of sexual and gender minority communities for health disparities research and the Ending the HIV Epidemic (EHE) initiative, as well as NIH priority areas for reducing HIV incidence. Findings will provide the necessary groundwork to examine intervention efficacy and implementation processes in a future, large-scale trial.