# Transgender-Specific Differentiated HIV Care: An Implementation Science Study

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $598,840

## Abstract

Transgender-specific Differentiated HIV Care Models:
 An Implementation Science Study
Project Summary/Abstract
Despite a disproportionate burden of HIV, transgender people are less likely to achieve viral suppression than
the general population and have low engagement in PrEP services. Intervenable barriers to their engagement
in HIV services include facility-based stigma and lack of access to gender affirming care, including hormone
therapy. Transgender-specific differentiated service delivery models have recently been implemented as
demonstration projects in South Africa, providing a unique opportunity to assess feasible and acceptable
implementation strategies as well as analyze the effectiveness and cost of integrating gender affirming
hormone therapy and stigma-reduction strategies into HIV care for transgender people. This observational,
multi-site, mixed methods prospective implementation study will be guided by the Gender Affirmation
Framework and the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) implementation
science evaluation framework to meet the following aims: (1) assess barriers, facilitators, acceptability, and
feasibility of transgender-specific differentiated service delivery using site observation checklists, key informant
interviews with facility staff, and longitudinal in-depth interviews with transgender clients; (2) evaluate the effect
of transgender-specific differentiated service delivery on viral suppression and PrEP adherence - testing
stigma and gender affirmation as mediators, using a longitudinal cohort of TGP clients that compares
transgender people enrolled at transgender-specific differentiated service delivery sites with transgender
people enrolled in standard service delivery sites (200/arm on ART and 100/arm on PrEP for a total N = 600);
and (3) estimate the cost associated with transgender-specific differentiated service delivery versus standard
service delivery sites using a micro-costing approach to estimate the cost per service user served and per
service user successfully treated at transgender-specific differentiated service delivery sites relative to
standard service delivery sites, as well as the budget needed for successful South Africa-wide implementation.

## Key facts

- **NIH application ID:** 10484026
- **Project number:** 1R01MH130277-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** John Chischolm Imrie
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $598,840
- **Award type:** 1
- **Project period:** 2022-04-15 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10484026

## Citation

> US National Institutes of Health, RePORTER application 10484026, Transgender-Specific Differentiated HIV Care: An Implementation Science Study (1R01MH130277-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10484026. Licensed CC0.

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