# Building mobile HIV prevention and mental health support in low-resource settings

> **NIH NIH R01** · RBHS-SCHOOL OF NURSING · 2021 · $100,000

## Abstract

Project Summary
Transgender and gender diverse (e.g., gender non-binary) (TGD) individuals remain a hidden group in the
Central Eastern European (CEE) country of Romania, with few protections, few equal rights, and many unmet
needs. Emerging research with TGD persons in the region indicates that TGD Romanians report particularly
high rates of HIV, depression, and hazardous alcohol use, primarily driven by the country’s high structural
stigma. Romania’s healthcare system has little expertise for addressing these syndemic health threats. No
targeted needs assessments or interventions exist to date in order to remedy these adversities and promote
the wellbeing of TGD in Romania, or anywhere in CEE – the region with the fastest-growing HIV epidemic in
the world. In response, we propose to create and pilot-test the first intervention in CEE to address the sexual,
mental, and behavioral health of TGD people. In 2014, with input from the Romanian LGBTQ community, we
created the Comunică [Communicate] intervention, which successfully helped reduce gay and bisexual men’s
HIV risk and hazardous alcohol use and improve their mental health. The intervention’s theory and techniques
are based on motivational interviewing and cognitive behavioral skills training as adapted for minority stress.
Live counseling sessions are delivered by text on a secure platform accessed on any mobile device, which is
responsive to participants’ high need for mobility and concealment. In this supplement, we propose to now
adapt and pilot-test Comunică to address the shared and unique minority stress determinants facing TGD
Romanians to reduce HIV risk, depression, and hazardous alcohol use. Our adaptation will be guided by the
gender minority stress framework that acknowledges unique TGD stressors, whose impact our intervention
intends to modify. In Aim 1 (mos 1-5), we will identify the unique health needs of Romanian TGD individuals
and modify the Comunică intervention to address them. We will interview 20 Romanian TGD individuals who
report HIV risk, depression, and hazardous alcohol use, and 10 TGD-affirmative health providers to identify
TGD-specific health needs and suggested adaptations to Comunică. In Aim 2 (mo 6), we will iteratively modify
the Comunică intervention content to address gender minority stress and other TGD-specific determinants of
HIV risk, mental health, and hazardous alcohol use. Finally, in Aim 3 (mos 7-12), we will evaluate the new
intervention’s feasibility and acceptability in a one-arm trial with 20 TGD Romanians who report HIV risk,
depression, and hazardous alcohol use. Data will be collected at baseline and 3-month follow-up. This project
builds on our strong NIH-supported research program focused on the health of LGBTQ people in Romania, in
order to create the first intervention to address the sexual, mental, and behavioral health of TGD Romanians.
By extending our intervention research to at-risk TGD populations, we will ensure more equitable ac...

## Key facts

- **NIH application ID:** 10332885
- **Project number:** 3R01MH116829-04S1
- **Recipient organization:** RBHS-SCHOOL OF NURSING
- **Principal Investigator:** Corina Lelutiu-Weinberger
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $100,000
- **Award type:** 3
- **Project period:** 2018-09-05 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10332885

## Citation

> US National Institutes of Health, RePORTER application 10332885, Building mobile HIV prevention and mental health support in low-resource settings (3R01MH116829-04S1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10332885. Licensed CC0.

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