# The BeT intervention to reduce HIV prevention and care disparities among young transwomen in Rio De Janeiro

> **NIH NIH UH3** · PUBLIC HEALTH FOUNDATION ENTERPRISES · 2022 · $258,580

## Abstract

ABSTRACT
Our recent research discovered that almost 25% of a population-based sample of young transwomen in Brazil
tested positive for HIV. This finding is consistent with research demonstrating that transwomen are the
population most severely affected by HIV worldwide and face important barriers to accessing effective
prevention and care programs. There is no HIV prevention intervention for young transwomen with evidence of
efficacy outside the US. We propose a two-phase combination prevention intervention to address the main
barriers to HIV prevention and care found in our research in this resource constrained setting. Stigma prevents
young transwomen from accessing HIV prevention and care services, despite the fact that such services are
freely available to all Brazilians in the public health system care system (i.e., SUS). Young people's HIV testing
levels and care access is uneven. Data from our study show that almost no young transwomen regularly got
tested for HIV, and given low testing levels, it is unlikely youth are accessing HIV care. In response to NICHD
RFA-HD-18-032, we propose the Brilho e Transcender (BeT, or Shine and Transcend) intervention for young
transwomen ages 18-24 years old in Brazil. Our proposed intervention uses expertise gleaned from a US
based cohort study of young transwomen and knowledge from our cross-sectional transwomen HIV risk study
in Brazil. Our study is comprised of two phases to address stigma in the public health system, intervene to
overcome youth challenges with health care systems navigation and to scale the intervention widely if proven
efficacious. During the 2-year UG3 phase, we propose to develop, implement and measure a highly visible,
community-informed social marketing campaign to reduce anti-trans stigma in four SUS clinics currently
implementing national PrEP access efforts that are also part of ImPrEP, which is a 3-country PrEP
implementation project focused on transgender individuals and MSM. During the UG3 phase, we will also
collect formative data to adapt our ARTAS-based system navigation intervention to the cultural context and
HIV prevention and care needs of young transwomen in Brazil. After adaptation, we will conduct a small pilot
intervention with 20 youth participants to determine preliminary efficacy and demonstrate our ability to
recruit youth in this population. Preliminary data gathered from the RCT in the UG3 phase will be used to refine
the intervention and justify movement to the UH3 phase and larger RCT to test efficacy of the intervention.
During the UH3 phase, we will conduct a RCT with 150 young transwomen randomized to the BeT
intervention or control. The intervention will be a digital systems navigation intervention utilizing peers to
address youth-specific barriers to HIV prevention and care- namely, risk perception, system navigation skills
and health literacy. The intervention will be intensively implemented over three months with follow-up to twelve
months. The co...

## Key facts

- **NIH application ID:** 10468192
- **Project number:** 5UH3HD096914-05
- **Recipient organization:** PUBLIC HEALTH FOUNDATION ENTERPRISES
- **Principal Investigator:** Erin Catherine Meek
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $258,580
- **Award type:** 5
- **Project period:** 2018-09-06 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10468192

## Citation

> US National Institutes of Health, RePORTER application 10468192, The BeT intervention to reduce HIV prevention and care disparities among young transwomen in Rio De Janeiro (5UH3HD096914-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10468192. Licensed CC0.

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