PROJECT SUMMARY/ABSTRACT Jamaica’s HIV/AIDS epidemic among sexual and gender minorities is the most severe in the Caribbean in terms of its breadth and consequences. HIV prevalence among men who have sex with men is estimated at 33% and 51% among transgender women, which is significantly higher than the 1.8% observe in the general population. Intersectional stigma (often related to intersecting identities) and violence are key drivers of poor mental health and HIV care engagement, leading to higher rates of depression, anxiety, and low viral suppression (21%). The goals of the proposed research are to 1) gain and understanding of the influences and mechanisms by which intersectional stigma and violence impact mental health and engagement in HIV care; and 2) refine our conceptual framework to aid in intervention development that assists sexual and gender minorities to engage in HIV care. Candidate: I am a nurse-scientist with a background in health behavior change theory and social determinants of health in the context of HIV. I am applying for a K23 Career Development Award to obtain training, mentorship, and research experience to become an expert and independent investigator in theory-based, behavioral intervention design to improve the health of sexual and gender minorities in the Caribbean and in other low-resource settings. Mentoring: I have put together an exceptional mentoring team with extensive experience in intersectional stigma measurement research, mental health, and HIV treatment and prevention in resource-limited settings like Jamaica. Drs. Sheri Weiser and Carol Dawson-Rose will serve as co-Primary mentors and bring complementary expertise in HIV treatment and prevention, trauma, conceptual model framework refinement, and development and implementation of behavioral interventions in resource-limited settings. My co-mentors, scientific advisor, and collaborator round out my team to bring specific content and methods expertise and are based both in the United States and Jamaica, including: Dr. Mallory Johnson (clinical psychologist, intervention design and evaluation; feasibility implementation, ART adherence); Dr. Tor Neilands (psychology, quantitative methods, design and analysis of longitudinal data); Dr. Sharlene Jarrett (clinical psychologist, mental health and HIV treatment in the Jamaican context); Carmen Logie (clinical social worker, intersectionality and mixed methods research); Dr. Jae Sevelius (clinical psychologist, intersectional stigma measurements, cognitive interviewing, and gender affirmation); Dr. Anita Stewart (psychologist, measurement adaptation and testing expert); and Dr. Mark Padilla (medical anthropologist, Caribbean sexualities researcher). Training: I propose to obtain training in acquiring foundational knowledge in measures of intersectional stigma (adaptation and testing), advanced quantitative training to collect and analysis skills, and to attain expertise in developing, piloting, and evaluating HIV be...